| Purpose:The main pathogenesis of acute coronary events is thrombus formation based on coronary atherosclerotic plaque rupture, early recognition of it has important significance. Serum amyloid A (SAA) is new inflammatory marker closely related to coronary plaque inflammation response, and may have significant value in early recognition of plaque inflammation. In this research, we were intending to evaluate the severity of coronary atherosclerotic lesions in patients with chest pain using coronary angiography and Gensini score; and using ELISA method to detect the serum levels of SAA of patients pre-operation and post-operation, and to analyze the relationship of serum levels of SAA and the severity of coronary atherosclerotic lesions in patients with chest pain. This study was to find a serum marker that can identify coronary atherosclerotic plaque flammation in early stage, and to explore the clinical significance of increasing early identification of coronary atherosclerotic plaque inflammation by serological testing combined with imaging detection.Methods:One hundred and eighty patients with acute chest pain admitted in department of Cardiology of our hospital from June 2014 to January 2015 were selected, including 92 cases male and 88 cases female patients, with an average age of (64.22±9.91) years. All patients enrolled with acute chest pain underwent coronary angiography, and coronary heart disease was diagnosed as local stenosis greater than or equal to 50% of diameter in at least one coronary artery. Patients were divided into coronary disease group and non-coronary disease group according to the results of coronary angiography, with 50 patients in non-coronary disease group as control. Patients in coronary disease group were further divided into 3 groups according to clinical symptoms and auxiliary examination results, including 40 cases in Stable angina pectoris(SAP) group.50 cases in Unstable angina pectoris (UAP) groups, and 40 cases in Acute Myocardial Infarction(AMI) group. On the next morning after admission, fasting venous blood samples were tested to determine the serum level of SAA, and all patients underwent coronary angiography. On the third morning after admission, fasting venous blood samples were tested to determine the serum level of SAA again. The severity of coronary artery disease was showed as vascular counts in the lesion and Gensini score. We compared the different severity of coronary artery disease, and observed the changes of SAA level before and after coronary angiography.Results:1. The SAA level in coronary disease group is higher than that in non-coronary disease group, the difference was statistically significant(P<0.05).2. In the comparison of SAA levels in patients with acute chest pain in different clinical subgroups showed that:1. The SAA levels in UAP and AMI groups were significantly higher than that in non-coronary disease group and SAP group (P<0.05). And the difference between SAP group and non-coronary disease group is not statistically significant(P>0.05), while AMI group had a higher SAA than that in UAP group, the difference was statistically significant.3. The serum SAA levels in non-coronary disease group, SAP group, UAP group and AMI group were in positive correlation.with Gensini scores (r=0.0357,P<0.05).4. In the comparison of serum SSA levels in patients with different numbers of involved coronary artery. The serum SAA levels in single vessel group, double vessel group and multivessel group were all higher than that in control group, the difference was statistically significant (P<0.05). The difference between double vessel group, multivessel group compared with single vessel group was statistically significant (P<0.05), while the difference between double vessel group and multivessel group was not statistically significant (P>0.05).5. Through the results of SPSS, the postoperative serum SAA level in patients with coronary disease had a declining trend compared to that pre-operation, the difference was statistically significant (P<0.05)Conclusions:1. The differences of serum SAA levels in different subgroups of patients with chest pain were statistically significant, the SAA levels in 4 group were in positive correlation with Gensini score, and were related with the severity of coronary artery disease.2. The SAA levels in coronary disease group were higher than that in non-coronary disease group. As indicator to predict plaque inflammation, serum SAA had a reference value in clinical evaluation of risk stratification in patients with acute chest pain and guidance on the treatment. |
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