| Objective: To explore the correlation between the soluble growth stimulation expressed gene 2 protein(s ST2)and monocyte count in peripheral blood and the severity of coronary artery disease and its prognosis.Methods: The patients who were sequential admitted to hospital for selective coronary artery angiography were included in the study group,and the selected patients were divided into the control group,simple lesions group of coronary heart disease,complex lesions group according to the results of the coronary artery angiography.Then,according to the syntax score,the group of complicated coronary heart disease lesions was further classified into the low-risk group(score≤22),medium-risk group(32≥score>22)and high-risk group(score>32).Collect general clinical data,related laboratory indicators,and coronary imaging data of each group of patients.Peripheral venous blood samples were collected on an empty stomach in the early morning before the operation.The monocytes were counted by a hematology analyzer,and the serum s ST2 concentration was detected by ELISA.ELISA method measured serum s ST2 concentration,follow up for 6-15 months.The observed endpoint events include major adverse cardiac events(MACE),all-cause death,stroke,and heart failure.Univariate analysis was used to screen out variables related to the onset of coronary artery complex lesions(P<0.05),and independent risk factors for coronary artery complex lesions were determined through Lasso regression and multivariate Logistic regression analysis;Spearman correlation analysis studies the correlation between peripheral blood s ST2 level,monocyte count and the severity of coronary artery complex lesions.Using Kaplan-Meier survival analysis method to study the prognosis of control group,coronary heart disease simple lesions group,coronary heart disease complex lesions low risk group,middle risk group,high risk group.The COX risk regression model was used to analyze the risk factors that affect the prognosis of coronary artery complex lesions.The observed endpoint events include major adverse cardiac events(MACE),all-cause death,stroke,and heart failure.Results: In 430 cases,the single-factor analysis showed that the s ST2 level of coronary heart disease patients(including simple lesions and complex lesions)was significantly higher than that of the control group(3449±1250 vs.2743±961 pg/m L,P<0.001);The levels of s ST2 in patients in the coronary artery simple lesions group,complex lesions low risk group,medium risk group and high risk group were3200±1406,3338±1064,3728±1228 and 4261 ±1235(pg/m L),and the differences between the s ST2 groups were statistically significant(P<0.001).The differences in age,monocyte count,fibrin,uric acid and lipoprotein A1 are also statistically significant.LASSO regression and Logistic regression analysis showed that s ST2 was independently correlated with coronary heart disease(P<0.001),and monocyte count was independently correlated with coronary heart disease(P<0.001).s ST2 was independently correlated with the severity of coronary artery complex lesions(P<0.001),and monocyte count were independently associated with the severity of coronary complex lesions(P<0.001).Pearson correlation analysis showed that monocyte count were positively correlated with s ST2 in both coronary artery complex lesions and non-complex lesions groups(r=0.3662,P<0.001 and r=0.6116,P<0.001,respectively).Spearman correlation analysis showed that s ST2 expression levels were positively correlated with coronary artery lesions severity(rs: 0.543,P<0.001).Peripheral blood monocyte count was positively correlated with the severity of coronary artery lesions(rs: 0.405,P<0.001).The ROC curve showed that the area AUC under the s ST2 pair coronary artery complex lesion curve was 0.726 and the area under the monocyte count curve was 0.686.Cox proportional risk regression analysis shows that the high level of s ST2 and monocyte count are related risk factors for patient death.Conclusion: Peripheral blood s ST2 level and monocyte count can be used as the important indicators to evaluate or predict the severity of coronary artery complex lesions,and both of s ST2 and monocyte count are also independent predictors of the prognosis of coronary artery complex lesions. |
PDF Full Text Request