The Relationship Of Heart-type Fatty Acid-binding Protein And SYNTAX Score In Patients With Non-ST Elevation Acute Coronary Syndrome

Objective:To study the relationship between heart-type fatty acid-bindingprotein (H-FABP) levels and SYNTTAX score in patients with Non-STelevation acute coronary syndrome （NSTEACS).Medthod:1The object of studyFrom February2012to December2013, a total of90patients withNSTEACS performed coronary angiography examination in Xingtai people’shospital were enrolled in this study.Exclusion criteria: history of myocardialinfarction, history of PCI, history of coronary artery transplantation, severechronic heart failure, dissecting aneurysm, serious liver and kidney functionabnormal, chronic lung disease, skeletal muscle diseases, mass movementbefore symptom onset, history of cerebral infarction, serious heart valvulardisease, cardiomyopathy, malignant tumor, autoimmune disease,stable angina,acute st-elevation myocardial infarction patients,with coronary interventionaltherapy contraindications,et al.2research methodeach patient’s clinical data was recorded,including gender, age, bodymass index, smoking history, family history, hyperlipidemia, hypertension,diabetes history, duiration time, past medical history, electrocardiogram,systolic blood pressure, heart rate, blood creatinine, blood glucose,etc.Onadmission to hospital,all the selected patients were collected a peripheralvenous blood sampling to test the H-FABP concentration, which wasquantitatively determined by the bi-directional lateral flow immunoassay. Ontreatment,each patient has been given drugs to expand coronary artery、anticoagulation、inhibit platelet aggregation、slow heart rate、reduct myocardial oxygen consumption, stable lipid plaque and inhibit myocardialremodeling.After sufficient preoperative preparation,all patients underwentcoronary angiography (CAG) to diagnose the coronary lesions.The coronaryartery lesion severity was evaluated by SYNTAX score.Then calculate andrecord each patient′s SYNTAX score. SYNTAX score was divided into low,medium, high3grade:0-22score for low group,23-32for medium group,with and above33points for high group. SPSS13.0software was used in thisstudy.Set up a database by，The correlation between H-FABP and SYNTAXscore was analyzed using Spearman correlation analysis. P <0.05wasconsidered statistically significantResult:1The comparison of baseline data between three groupsThe baseline data of the three groups (gender, age, body mass index,angina/NSTEMI, smoking history, family history, history of hyperlipidemia,hypertension, diabetes history, past medical history, systolic blood pressure,heart rate, serum creatinine, fasting plasma glucose and other clinical data）have no statistical difference,(P>0.05).The comparison of parelectrocardiogram (ECG)between the groups: Thehigh score group：accompanied by left bundle branch block (LBBB)4cases(16%),accompanied by aVR ST-elevation3cases (12%), malignant arrhythmia3cases （12%）; The medium group： accompanied by LBBB4cases(12.5%),accompanied by aVR ST-elevation2cases (6.25%), malignantarrhythmia1case(3.12%);The low group:accompanied by left bundle branchblock(LBBB)3cases(9.09%),accompanied by aVR ST-elevation1cases(3.03%),malignant arrhythmia0cases(0%).Comparison between three groups, in thehigh group ST segment, LBBB cases and malignant arrhythmia are most. themedium score group is followed.In low score group,LBBB cases andmalignant arrhythmia are lest.Every comparison between the three groupshave statistical significance, P<0.05.2The comparison of coronary angiography characteristics beteen the threegroups Coronary angiography results show that in high score group: single lesion0cases(0%), multivessel lesions14cases(56%), complex lesions11cases(chronic occlusion lesion, long diffuse lesions and left main lesion, ostial,bifurcation lesions, vascular severely distorted lesions)(44%). The mediumscore group: single lesion6cases(18.75%), multivessel lesions16cases (50%),complex lesions10cases(31.25%). The low score group: single lesion23cases(69.69%), multivessel lesions7cases(21.21%), complex lesions3cases(9.09%). Comparison between the three groups, multivessel lesions andcomplex lesions cases in high score group is most,and coronary artery lesionsis heaviest. The medium score group is followed.The single lesion cases inlow score group is most, and coronary artery lesion is the lightest.Everycomparison between the three groups have statistical significance, P<0.05.3The comparison of plasma H-FABP levels beteen three groupsIn high score group,the mean value of plasma H-FABP is41.48±9.42ng/ml.The mean value of plasma H-FABP in the medium score groupis27.99±7.5ng/ml.And the mean value of plasma H-FABP in the low scoregroup is15.34±11.48ng/ml.Comparison between three groups, plasma H-FABPlevel in the high score group is highest.The medium score group isfollowed.The low score group is lowest Every comparison between the threegroups have statistical significance, P<0.05.4Relationship of plasma H-FABP and SYNTAX scoreWith the Spearson correlation analysis,we found that plasma H-FABPlevel(27.10±1.49)was positively linear correlated with SYNTAX score(24.04±0.95) in NSTEACS patients.The correlation coefficient is0.794, P<0.05.Conclusion:The plasma H-FABP level is positive correlated with SYNTAX score inNSTEACS patients.The higher plasma H-FABP levels, the higher SYNTAXscore,and the more serious the coronary artery lesions. Plasma H-FABP levelshas linear correlation with the SYNTAX score, so the level of plasma H-FABP can quickly reflect coronary artery lesion severity in NSTEACS patients.