Plasma Levels Of Visfatin In Patients With Coronary Heart Disease And Its Clinical Significance

Objectives:To explore the clinical value of visfatin in risk stratification and plaque destabilization of coronary heart disease(CHD) through detecting plasma levels of visfatin in the patients with CHD, and observing the correlativity between plasma visfatin levels with the degree of coronary heart disease and coronary artery stenosis.Methods:A total of95subjects were recruited in the study. They were from the inpatients in the cardiovascular department of the first affiliated hospital of university of south China, who were undergone coronary angiography (CAG) during Mar.2011to May.2012.1. Based on clinical manifestations, ECG, the levels of serological indexes and the results of CAG, the subjects were divided into non-CHD group(38cases) and CHD group(57cases).CHD group was further classified into two subgroups: stable angina pectoris (SAP) group(27cases) and acute myocardial infarction(AMI) group(30cases).2.According to the median level of visaftin(M=0.27ng/ml), all subjects were divided into two groups:A group with plasma visfatin levels<0.27ng/ml, B group with plasma visfatin levels>0.27ng/ml.3.According to the number of coronary lesion, the CHD group was divided into three subgroups: single-vessel lesion group(16cases), double-vessel lesions group(18cases), and triple-vessel lesions group(23cases). The quantitative assess of the severity of coronary artery lesion was made according Gensini score standards. The degree of coronary artery stenosis was evaluated by the sum of the Gensini scores and the number of coronary lesion. The levels of plasma visfatin were analyzed by enzyme-linked immunosorbent assay (ELISA). Moreover, height(HT), weight(WT), blood pressure(BP), body mass index(BMI)were measured, generally selected biochemical parameters such as the levels of fasting plasma glucose(FPG), triglyceride(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), high sensitivity C-Reactive Protein(hs-CRP), erythrocyte sedimentation rate(ESR), high sensitive troponin T(cTnT), creatine kinase(CK) and MB isoenzyme of creatine kinase(CK-MB) were also detected in the laboratory. The difference on visfatin was compared among subgroups and groups. The correlations between visfatin and other parameters were investigated by multiple linear stepwise regression analysis.Results:1.The plasma levels of visfatin were significantly elevated in CHD group compared with non-CHD group[(0.41±0.28)ng/ml vs.(0.20±0.21)ng/ml,(P<0.05)].2.The plasma levels of visfatin in AMI group were higher than those of non-CHD group [(0.47±0.25)ng/ml vs.(0.20±0.21)ng/ml,(P<0.05)] and those of SAP group[(0.47±0.25)ng/ml vs.(0.33±0.30) ng/ml,(P<0.05)]; the plasma levels of visfatin in SAP were higher than those of non-CHD group[(0.33±0.30)ng/ml vs.(0.20±0.21) ng/ml,(P<0.05)].3. The risk ratio of AMI is6.83fold of patients with plasma visfatin levels>0.27ng/ml compared with patients with plasma visfatin levels<0.27ng/ml.4.The levels of plasma visfatin in three-vessel lesions group were higher than those of non-CHD group [(0.46±0.30) vs.(0.20±0.21)ng/ml,(P<0.05)] and those of single-vessel lesion group[(0.46±0.30) vs.(0.30±0.22)ng/ml,(P<0.05)]; The levels of plasma visfatin were higher in double-vessel lesions group than non-CHD group [(0.43±0.29) vs.(0.20±0.21)ng/ml,(P<0.05)]; the plasma levels of visfatin were increased in turn in single-vessel lesion group, double-vessel lesions group and three-vessel lesions group, which were (0.30±0.22)ng/ml,(0.43±0.29)ng/ml and (0.46±0.30)ng/ml respectively.6. Correlation analysis showed that the plasma levels of visfatin were positively correlated with TG、TC、hs-CRP, the number of coronary artery lesion and the Gensini scores(r=0.391、0.386、0.611、0.417、0.482, respectively, all P<0.05), negatively correlated with HDL-C(r=-0.404,P<0.05); Multiple stepwise regression analysis revealed that hs-CRP, Gensini scores to be independent determinants of visfatin(F=15.905,P<0.01).Conclusions:1.The levels of plasma visfatin is closely related with the degree of coronary artery stenosis, visfatin may became a serological marker for predicting coronary lesions extent;2.The plasma levels of visfatin exist positive correlation with the risk of AMI event occurence.