The Relationship Of Lp-PLA2 With Main Adverse Cardiovascular Events In Patients With Acute Coronary Syndrome

Objects:To analyze the effect of lipoprotein-associated phospholipase A2(Lp-PLA2)on Acute Coronary Syndrome and the relationship between Lp-PLA2 and the occurrence of Major Adverse Cardiovascular Events in patients with Acute Coronary Syndrome.Methods:362 patients with coronary heart disease(CHD)from the Department of Cardiology,Xinmin Hospital,China-Japan Union Hospital of Jilin University from October 2019 to November 2020 were selected as the research objects.According to coronary angiography(CAG)results,electrocardiography,cardiac biomarker,and clinical presentation,152 inpatients diagnosed with stable anginal stable angina pectoris(SAP)were selected as the SAP group and 210 inpatients diagnosed with Acute Coronary Syndrome(ACS)were selected as the ACS group.The differences in traditional risk factors and Lp-PLA2 activity between ACS group and SAP group were compared.The value of the influence of Lp-PLA2 activity on ACS in patients with coronary heart disease was analyzed by Logistic regression analysis.The diagnostic significance of Lp-PLA2 activity on ACS in patients with coronary heart disease was evaluated by receiver operating characteristic curve.All research objects were followed up for 12 months by phone calls or outpatient visits.The occurrence of Major Adverse Cardiovascular Events(MACE)in all patients were recorded,including angina pectoris,myocardial infarction,heart failure,cardiac death and revascularization.Depending on whether MACE occurs,ACS patients were divided into MACE group and non-MACE group.The differences in traditional risk factors,c Tn I and Lp-PLA2 activity between MACE group and non-MACE group were compared.The value of the influence of Lp-PLA2 activity on MACE in patients with ACS was analyzed by Logistic regression analysis.The diagnostic significance of Lp-PLA2 activity on MACE in patients with ACS was evaluated by receiver operating characteristic curve.Results:1.The Lp-PLA2 activity in the ACS group was significantly higher than that in the SAP group(Z=-6.706,P<0.001).2.Elevated Lp-PLA2 activity increases the risk of ACS in patients with CHD(OR=1.02,95%CI 1.01-1.02,P<0.001).3.The accuracy of Lp-PLA2 activity in predicting ACS in patients with coronary heart disease was 70.6%,the sensitivity was 70.0%,and the specificity was 65.13%.4.Lp-PLA2 activity was significantly higher in ACS patients with MACE than in ACS patients without MACE(Z=-6.197,P<0.001).5.Elevated Lp-PLA2 activity increases the risk of MACE in patients with ACS(OR=1.02,95%CI 1.01-1.02,P<0.001).6.The accuracy of Lp-PLA2 activity in predicting MACE in ACS patients was 77.0%,the sensitivity was 69.84%,and the specificity was72.77%.The accuracy of Lp-PLA2 activity combined with c Tn I in predicting the occurrence of MACE in ACS patients was 77.2%,the sensitivity was 74.60%,and the specificity was 72.79%.Conclusion:Elevated Lp-PLA2 activity may increase the risk of ACS in patients with coronary heart disease,and can provide a good predictive value for the occurrence of MACE in ACS patients 1 year after PCI.