Study Of Copeptin And The Coronary Lesions Degree

Objective:To detect plasma copeptin levels in patients with acute coronarysyndrome and healthy people.To study the different levels of plasma copeptin inpatients with one coronary artery lesions group、 two coronary arteries lesions group、three coronary arteries lesions group and left main coronary artery lesionsgroup.To observe the correlation between plasma copeptin and sex,age,body massindex(BMI),blood glucose(BP), total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol HDL-C), low-density lipoprotein-cholesterol(LDL-C), Aspertate minotransferase (AST), Cereal third transaminase(ALT), sodium(Na) potassium(K),calcium(Ca),creatinine(CRE),uric acid(UA),urea(UREA), glucose(GLU),albumin(ALB).Methods: We used case-control study in this paper. From June2011to December2011,120patients（aged40to79years old) who underwent coronary angiograph at the First Affiliated Hospital of Dalian Medical University, Department of Cardiology were hospitalized with chest pain or chest tightness,(87males and33females, average age:63.10±11.13).120patients were divided into acute coronary syndrome group and control group by coronary angiograph. Control group (29cases,15males and14females, aged40to79years old, average aged67.34±8.69) was defined as stenosis≤25%luminal diameter (quantitative coronaryangiography).;Group ACS:91patients were diagnosed to be acute coronary syndrome with at least one coronary artery of the left main, left anterior descending, left circumflex or right coronary artery showing stenosis more than50%of its luminal diameter by coronary angiography. According to clinical symptoms, cardiac marker test and electrocardiogram results, patients were classified into two groups as: unstable angina (UA,45cases,33males and12females, aged40to79years old, average age:62.36±9.20) and acute myocardial infarction(AMI,46ca ses,39males and7females, aged40to79years old, average age:61.15±13.48). Group ACS was classified into4groups, single-vessel disease group(32cases,26males and6females, aged40to79years old, average age:59.00+11.04)),double branch(22cases,17males and5females, aged40to79years old, average age:62.39±8.72)、3branch(24cases,19males and5females, aged40to79years old, average age:62.10+11.68) and left main coronary artery lesion group(13cases,10males and3females, aged40to79years old, average age:64.38±10.00).ACS group can also be divided into the following four groups accordingto Gensini scores: the first group(Gensini score≤5,20cases,13males and7females, aged40to79years old, average age:59.38±8.71); the second group(6<Gensini score<10,28cases,25males and3females, aged40to79years old, average age:60.28±9.13); the third group(11<Gensini score <15,13cases,9males and4females, aged40to79years old, average aged60.75±8.59); the last group(16<Gensini score <20,30cases,25males and5females, aged40to79years old, average aged61.58±9.76). patients with pulmonary hypertension, pulmonary heart disease, severe liver and kidney dysfunction, blood diseases, malignant tumor, severe infection, history of myocardial infarction and heart failure wereexcluded. All patients’blood pressure、weight、height were measured and BodyMass Index (BMI) was calculated. The blood samples of subjects were obtainedfrom the antecubital vain after an overnight fasting period more than8th for measurement of serum Total cholesterol(TC)、Triglycerides(TG) high-density lipoprotein cholesterol(HDL-C),Low-density lipoprotein cholesterol(LDL-C), Aspertate aminotransferase (AST)、Cereal third transaminase（ALT）、 Urine acid (UA)、Urea (UREA)、 Fasting plasma glucose (FPG), albumin(ALB) and copeptin in themorning. The plasma level of copeptin was detected by enzyme linked immunosorbent assay (ELISA) in the next morning of admission.Results:(1) The plasma copeptin level in unstable angina group (19.97+3.69pmol/l)was higher than that in normal control group (14.08+1.86pmol/l, p<0.05);The plasma copeptin level in acute myocardial infarction group （24.14+5.13pmol/l）was higher than that in normal control group (14.08+1.86pmol/l, p<0.05) and in unstable angina group (19.97+3.69pmol/l, p<0.05);(2)The Gensini integral in unstable angina group and in normal control group were positively correlatedwith the copeptin.(3) The plasma copeptin level in three coronary arteries lesionsgroup（23.07+6.47pmol/l）was higher than that in one coronary artery lesions group(21.72+5.07pmol/l)、two coronary arteries lesions group（22.06+3.26pmol/l）;(4) The plasma copeptin level in left main lesions group（24.02+4.39pmol/l）was higher than that in one coronary artery lesions group(21.72+5.07pmol/l)、two coronary arteries lesions group （22.06+3.26pmol/l）;(5) The plasma copeptin level in16-20points group(25.67+3.28pmol/l) was higher than that in≤5points group（18.756+2.13pmol/l, p<0.05）、6-11points group（19.89+3.12pmol/l, p<0.05）; The plasma copeptin level in11-15points group （21.34+2.45pmol/l）was higher than that in≤5points group（18.756+2.13pmol/l, p<0.05）.Conclusion:(1) The plasma copeptin level and coronary heart disease degreeof coronary lesions were positively correlated.(2) The plasma copeptin level maybecome the early prediction criteria and risk factors for stratification of ACS.