The Correlation Between The Level Of Serum Neuregulin-4 And The Degree Of Coronary Artery Stenosis In Patients With Acute Coronary Syndrome

Background : Neuregulin-4,a member of the epidermal growth factorfamily,is rich in brown adipose tissue and plays multiple biological roles by binding to Erb B4 receptors on the cell membrane of target organs.A large number of animal and clinical trials have proved that NRG-4 plays an active role in regulating glucose and lipid metabolism,obesity and obesity-related metabolic disorders,improving insulin resistance,and predicting type 2 diabetes.However,there are few reports on the role of NRG-4 in the pathogenesis of coronary heart disease and the correlation between NRG-4 and the degree of coronary artery stenosis.Objective: to investigate the changes of NRG-4 level in patients with acute coronary syndrome and its correlation with the degree of coronary artery stenosis.Methods: A total of 149 patients who were hospitalized in the second Hospital of Hebei Medical University from February 2020 to December 2020 were divided into acute coronary syndrome group and normal control group according to their symptoms,auxiliary examination and coronary angiography results.According to the clinical manifestation,laboratory index and electrocardiogram,the patients were divided into two groups: acute coronary syndrome group and normal control group.The ACS group was further divided into ST segment elevation myocardial infarction group and non-St segment elevation ACS group.The ACS group was also divided into low risk group,medium risk group and high risk group according to SYNTAX score.The general clinical data and biochemical indexes of the subjects were collected,and the level of serum NRG-4 was detected by enzyme-linked immunosorbent assay.The data were analyzed and processed by SPSS 25.0 statistical software.Result:The level of serum NRG-4 in CON group was significantly higher than that in ACS group(43.43±18.77pg/m L VS.30.59±11.80pg/m L,P<0.01).There was no significant difference in serum NRG-4 level between NSTEACS group and STEMI group(33.08±9.73pg/m L VS.26.03±13.90pg/m L,P>0.05).The level of serum NRG-4 was negatively correlated with the ejection fraction(r=-0.31,P<0.01)and the SYNTAX score(r=-0.67,P<0.01).The results of multiple linear regression showed that NRG-4 was an independent risk factor for the degree of coronary artery stenosis(β=-0.62,P<0.01).Conclusion: the level of serum NRG-4 in patients with ACS is significantly decreased and negatively correlated with SYNTAX score,suggesting that NRG-4 may play a protective role in the occurrence and development of ACS,and its decrease may be a good index to predict the occurrence of ACS and the degree of coronary artery stenosis in the future.