Expression Level Of PCSK6-soluble Corin-natriuretic Peptide Pathway In ACS Patients And Its Correlation With Coronary Artery Disease Severity And Short-term Prognosis

Part 1 Expression level and diagnostic value of PCSK6-soluble Corin-natriuretic peptide pathway in ACS patientsObjective To analyze the expression and diagnostic value of proprotein convertase subtilisin kexin 6(PCSK6),soluble Corin,and N-terminal B-type natriuretic peptide precursor(NT-proBNP)in each subtype of acute coronary syndrome(ACS).Methods 132 ACS patients who were treated in our hospital from 2020-12 to 2021-8 were selected as the case group,including unstable angina pectoris(UA),acute non-ST-segment elevation myocardial infarction(NSTEMI)and acute ST-segment elevation myocardial infarction(STEMI)with 44 cases in each group.Twenty patients who were excluded from coronary heart disease diagnosis during the same period were included as the control group.The expression of PCSK6-soluble Corin-NT-proBNP in each group was analyzed,and its correlation with relevant clinical indicators in ACS patients was analyzed,and ROC curve was used to analyze its value in diagnosing ACS and its subtypes.Results ①Compared with the control group and the UA group,the expression of Corin in the NSTEMI group and the STEMI group was decreased,and the expression of PCSK6 was increased;Except for the UA group compared with the control group,NT-proBNP was differentially expressed in the control group and ACS sub groups(all P<0.05).②PCSK6 was positively correlated with cTnT/CK-MB and negatively correlated with LVEF;Corin was negatively correlated with GRACE score,cTnT/CK-MB,and positively correlated with FS/LVEF;NT-proBNP was positively correlated with GRACE score/CRUSADE score,WBC/NLR/Hs-CRP,cTnT/CK-MB and LVESV,and negatively correlated with FS/LVEF(all P<0.05)③Compared with PCSK6 low level group,PCSK6 high level group had higher GRACE score and cTnT/CK-MB;Compared with Corin low level group,Corin high level group had higher FS;Compared with the NT-proBNP low level grou),the NT-proBNP high level group had higher GRACE score/CRUSADE score,WBC/NLR/Hs-CRP,cTnT/CK-MB,LVESV,and lower FS/LVEF(all P<0.05).④The ROC curve showed that the area under the curve(AUC)of PCSK6 and NT-proBNP for diagnosing ACS were 0.641 and 0.886,respectively;And the AUC of NT-proBNP in diagnosing UA was 0.707;The AUCs of PCSK6,Corin,and NT-proBNP for diagnosing AMI were 0.696,0.688,and 0.976,respectively;The AUCs of PCSK6,Corin and NT-proBNP to differentiate AMI from UA were 0.631,0.681 and 0.953,respectively(all P<0.05).Conclusion In ACS patients,especially AMI,there are differences in the expression of PCSK6-soluble Corin-NT-proBNP pathway,which has certain value in disease assessment and differential diagnosis.Part II Correlation of PCSK6,soluble Corin,NT-proBNP expression levels with the severity of coronary artery disease and short-term prognosis in ACS patientsObjective To analyze the relationship between the expression of PCSK6,Corin and NT-proBNP in patients with acute coronary syndrome(ACS)and the severity of coronary artery disease and major adverse cardiovascular and cerebrovascular events(MACCE)in the hospital.Methods A total of 132 ACS patients who were treated in our hospital from 2020-12 to 2021-8 were selected as the case group,and 20 patients with coronary heart disease excluded during the same period were included as the control group.The number of coronary artery disease vessels and the modified Gensini score were used to assess the severity of coronary artery disease.According to the number of coronary artery disease vessels,ACS patients were divided into single-vessel disease group,two-vessel disease group and three-vessel disease group;according to the tertiles of modified Gensini score,ACS patients were divided into mild stenosis group,moderate stenosis group and severe stenosis group;according to whether major adverse cardiovascular and cerebrovascular events occurred in the hospital,ACS patients were divided into MACCE group and non-MACCE group.The expressions of PCSK6,Corin and NT-proBNP in each group were analyzed,and their correlation with the severity of coronary artery disease was analyzed by Spearman method.Logistic regression model was used to explore the risk factors of high Gensini score and in-hospital MACCE.Results ①The levels of PCSK6,Corin and NT-proBNP were not significantly different in single-vessel disease group,two-vessel disease group and three-vessel disease group(all P>0.05).②There was no statistical difference in the level of PCSK6 between the mild stenosis group,the moderate stenosis group and the severe stenosis group(P>0.05);compared with the mild stenosis and moderate stenosis group,the Corin level of the severe stenosis group was significantly lower,and the NT-proBNP levels was increased significantly(all P<0.05).③The number of coronary artery disease vessels was negatively correlated with Corin,and positively correlated with NT-proBNP;Gensini score was positively correlated with PCSK6,NT-proBNP,and negatively correlated with Corin(all P<0.05).④Logistics regression analysis showed that hyperglycemia,lg(NT-proBNP)were risk factors of high Gensini scores,and lg(Corin)was a protective factor(all P<0.05).⑤Compared with the non-MACCE group,the level of Corin decreased and the level of NT-proBNP increased in the MACCE group(all P<0.05);Logistic regression showed that only 1g(NT-proBNP)was an independent risk factor for MACCE.Conclusion The levels of PCSK6,Corin and NT-proBNP are related to the severity of coronary artery disease and the occurrence of MACCE in the hospital,and they have certain value in evaluating the severity and prognosis of the disease.