Study On The Relationship Between Non-hDL-C,LP(a)levels And The Degree Of Coronary Artery Disease In Patients With Coronary Heart Disease

Objective To investigate the correlation between the degree of coronary artery disease in patients with coronary heart disease(CHD)and serum levels of non-high-density lipoprotein cholesterol(Non-HDL-C)and lipoprotein(a)[LP(a)],and to evaluate the predictive value of Non-HDL-C and LP(a)levels on the degree of coronary artery stenosis in patients with CHD.Methods A total of 200 patients receiving coronary angiography admitted to the Department of Cardiology of The Third Affiliated Hospital of Anhui Medical University from August 2019 to August 2020 were selected.According to the angiography results,the experimental group was divided into 97 cases of mild coronary artery stenosis group,80 cases of moderate coronary artery stenosis group,and 23 cases of severe coronary artery stenosis group.Fifty cases of normal coronary angiography during the same period were selected as the control group.The difference of serum non-HDL-C and LP(a)levels in four groups was compared,and the influence of Non-HDL-C and LP(a)levels on the degree of coronary artery disease in CHD patients was tested by Logistic regression analysis,and the predictive value of Non-HDL-C and LP(a)levels on the degree of coronary artery stenosis in patients with CHD was evaluated by receiver operating characteristic(ROC)curve.Results(1)Comparison of basic data between the experimental group and the control group:There was no significant difference in gender,age,smoking history and diabetes history between the experimental group and the control group(P > 0.05).The levels of TC,TG,LDL-C,non-HDL-C and LP(a)in the experimental group were higher than those in the control group,while the level of HDL-C in the experimental group was lower than that in the control group,with statistical significance(P < 0.05).(2)Comparison of blood lipid levels between mild stenosis group,moderate stenosis group,severe stenosis group and control group:There were statistically significant differences in TC,TG,LDL-C,HDL-C,non-HDL-C,LP(a)levels between the mild stenosis group,moderate stenosis group and severe stenosis group and the control group(P < 0.05).In terms of TG level,there was statistically significant difference between moderate stenosis group and mild stenosis group(P < 0.05),while there was no statistically significant difference between severe stenosis group and moderate stenosis group(P > 0.05).There was no significant difference in TC and HDL-C levels between the moderate stenosis group and the mild stenosis group,and between the severe stenosis group and the moderate stenosis group(P > 0.05).There were statistically significant differences in LDL-C,non-HDL-C and LP(a)levels in the mild stenosis group,moderate stenosis group and severe stenosis group(P < 0.05),and the levels of LDL-C,non-HDL-C and LP(a)gradually increased with the increase of the severity of coronary artery lesions.(3)Multivariate Logistic regression analysis of the degree of coronary artery stenosis in patients with CHD:The serum levels of LDL-C,LP(a)and Non-HDL-C in 2 groups were significantly different in univariate analysis,which played a certain role in the progression of coronary artery disease in patients with CHD.Multivariate Logistic regression analysis was performed on the above factors,and the results showed that serum LDL-C concentration had no statistical difference among the mild,moderate and severe coronary stenosis groups(P=0.597).There were statistically significant differences in serum Non-HDL-C concentration and LP(a)concentration(P < 0.05,0.013 and 0.009,respectively).The OR value of Non-HDL-C was 1.275,and 95%CI was1362~2.754.The OR value of Lp(a)was 1.831,and 95%CI was 1.705~.279.(4)Predictive value of Non-HDL-C,LP(a)levels and combined factors on the degree of coronary artery stenosis in patients with CHD:Serum concentration of non-in HDL-C ROC curve line covers an area of 0.684,standard error is 0.416,95% CI 0.523 ~ 0.781,P < 0.001,there is statistical significance,cutoff value tendency for 3.41 L,50.1% sensitivity and 82.0% specific degrees.Lp(a)concentration of ROC curve line covers an area of 0.623,standard error is 0.042,95%CI CI 0.496~0.715,P < 0.001,there is statistical significance,cutoff value is 236.2mg/d L,49.5% sensitivity and 73.0% specific degrees.Both factors of ROC curve line covers an area of 0.704,standard error is 0.039,95% CI 0.634 ~0.798,P < 0.001,there is statistical significance,cutoff value tendency for 0.583 L,67.3% sensitivity and69.0% specific degrees.Conclusion(1)Serum Non-HDL-C and LP(a)levels are risk factors for the progression of coronary artery stenosis in patients with CHD,and can be used as an indicator to evaluate the degree of coronary artery disease;(2)The predictive value of serum Non-HDL-C combined with LP(a)on the degree of coronary artery stenosis in patients with CHD was better than the single predictive value of Non-HDL-C or LP(a).