| ObjectiveThis study aims to explore the correlation between serum cystatin C(Cys-C)levels and coronary artery Gensini scores in patients with acute coronary syndrome(ACS),and further explore the value of serum Cys-C levels in assessing the severity of coronary artery disease in patients with ACS.MethodsA total of 150 patients with acute coronary syndrome,admitted to the Department of Cardiology,the Second Affiliated Hospital of Shenyang Medical College from December 1,2021 to June 30,2022,who underwent coronary angiography,were selected.According to clinical symptoms,electrocardiogram and myocardial enzyme analysis,150 patients were divided into unstable angina pectoris group 50 cases,non-ST elevation myocardial infarction group 50 cases and ST elevation myocardial infarction group 50 cases.In the same period,30 patients with suspected coronary heart disease were treated as the control group.The general information of the enrolled patients,including age,gender,history of hypertension,history of diabetes,etc,All the enrolled patients were collected by fasting blood on the first day of admission or in the morning of the next day to determine the serum cystatin C level and other related serological indexes;The Gensini score of patients with ACS was calculated based on the results of coronary angiography.Patients with ACS were divided into mild lesion group(23 cases),20-40 into moderate lesion group(35 cases),and>40 into severe lesion group(92 cases).The serum Cys-C level and Gensini score of the control group,UA group,NSTEMI group,and STEMI group were observed,and the differences between the groups were compared.For patients with ACS of different clinical types,the expression of serum Cys-C level was compared in the mild,moderate,and severe coronary artery disease groups,and the correlation between serum Cys-C level and coronary artery Gensini score was analyzed.Statistical software SPSS29.0 was used to process the experimental data,and the counting data was expressed by case number or percentage.Chi-square test was used to compare the differences among the groups.Measurement data: conforming to normal distribution was expressed in the form of mean ± standard deviation;one-way analysis of variance was used for comparison between groups;non-conforming to normaldistribution was expressed in the form of median(quartile distance),namely M(Q1,Q3);Kruskal-Wallis H test was used for comparison between groups.Spearman correlation analysis was used to analyze the correlation between serum Cys-C levels and the severity of coronary artery disease in patients with ACS.Setting the test level to P<0.05 has statistical significance.Results1、The baseline data of the control group,UA group,NSTEMI group and STEMI group were compared.It was found that there were no statistically significant differences in gender,age,hypertension history,diabetes history,smoking history,drinking history,WBC,HGB,BUN,Scr,UA,FIB,TC,HDL-C,LDL-C,TG,BG in each group(P>0.05).2、Using Kruskal Wallis H test,the results showed that the serum Cys-C levels,Gensini scores,c Tn I levels,and NT-pro BNP water levels in the control group,UA group,NSTEMI group,and STEMI group were not identical on average,and the difference was statistically significant(P<0.001).(1)The results of pairwise comparison show that:(1)The serum Cys-C level in NSTEMI group was significantly higher than that in control group and UA group,but the serum Cys-C level in STEMI group was significantly lower than that in control group and UA group,with significant differences between groups(P<0.05);(2)The coronary Gensini scores in the UA group,NSTEMI group,and STEMI group were higher than those in the control group,and the coronary Gensini scores in NSTEMI group and STEMI group were higher than those in the UA group.The differences between the groups were statistically significant(P<0.05);(3)The serum c Tn I levels and NT-pro BNP water levels in the NSTEMI group and STEMI group were significantly higher than those in the control group and UA group,and the STEMI group was higher than the NSTEMI group.The differences between the groups were statistically significant(P<0.05).3、In patients with ACS of different clinical types,Kruskal Wallis H test was used,and the results showed that the levels of serum Cys-C in the mild,moderate,and severe coronary artery lesions groups were not completely the same,and the difference was statistically significant(P<0.05).(1)Inter group comparison results show:(1)UA group: The serum Cys-C level in the severe coronary artery disease group was significantly higher than that in the mild and moderate coronary artery disease groups(P<0.05);The serum Cys-C level in patients with moderate coronary artery disease was higher than that in patients with mild coronary artery disease,but the difference was not statistically significant(P>0.05);(2)NSTEMI group: The serum Cys-C level in the group with severe coronary artery disease was higher than that in the group with mild coronary artery disease and the group with moderate coronary artery disease,and the serum Cys-C level in the group with moderate coronary artery disease was higher than that in the group with mild coronary artery disease.The difference between groups was statistically significant(P<0.05);(3)STEMI group: The serum Cys-C level in the group with severe coronary artery disease was significantly higher than that in the group with mild coronary artery disease and the group with moderate coronary artery disease(P<0.05);However,there was no significant difference between the moderate coronary artery disease group and the mild coronary artery disease group(P>0.05).4、Spearman correlation analysis was used to test the correlation between serum Cys-C level and coronary artery Gensini score.The results showed that serum Cys-C level was correlated with coronary artery Gensini score,and there was a positive correlation between UA group and STEMI group(P<0.05);There was a significant positive correlation in the NSTEMI group(P<0.001).Conclusion1、In patients with ACS,the serum Cys-C level is positively correlated with the coronary artery Gensini score.As the severity of coronary artery disease increases,the serum Cys-C expression level is upregulated.2、The serum Cys-C level can provide a certain reference for predicting the severity of coronary artery disease in ACS patients.3、The level of serum Cys-C varies among ACS patients with different clinical types,which may have some significance in the evaluation of clinical classification of ACS patients in the future. |
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