| Objective: To investigate clinical significance of copeptin and AVPR2 m RNA in patients with Acute Coronary Syndrome by detecting copeptin and AVPR2 m RNA levels with unstable angina pectoris(UAP),acute myocardial infarction(AMI).Methods:For the case-control study,154 patients were included of the First Hospital Affiliated to Dalian Medical University between May 2013 and December2014 with the chief complaint of chest pain.ACS group included 118 cases, including67 males, aged from 42 to 82 years and the mean age was 63.4 ± 10.6 years; 51 females,aged 43-85 years, mean age 64.7 ± 9.5 years. UAP44 cases, AMI74 cases. The control group had 36 patients, including 20 males, aged 41-75 years, mean age 59.3 ± 9.78years; 16 females, aged 47-81 years, mean age 60.8 ± 9.8 years. All the patients underwent lipid, renal function, BNP, echocardiography and cardiac enzymes exams.Patients whose diameter stenosis of left main, left anterior descending artery, the left circumflex artery and the right coronary artery or any one major branch vessels(including the obtuse marginal branch, acute marginal branch, diagonal branch) ≥50%counted as ACS group, ≤ 25% counted as a control group. The severity of coronary artery disease in patients with ACS in accordance with Gensini score, divided into the following three levels: <20 scores 56 cases, 20~40 scores 46 cases,>40 scores 52 cases, counted 1、2、3 group.According to the number of coronary arteries were divided into: single-vessel disease in 25 cases, double vessel disease in 51 cases, three lesions in35 cases,7 cases of left main disease. Then the relationships between copeptin level and AVPR2 m RNA levels in different CHD types and severity of coronary stenosis were analyed.The result:1. In the control group, UA group and AMI group,Copeptin levels were 9.7±3.05、28.49±4.61、45.93±5.12 and AVPR2 m RNA levels were 1.02±0.49、1.69±1.02、2.08±0.968.Copeptin levels and AVPR2 m RNA levels were increased in turn in the three groups and the differences between the two groups were significant. Copeptin levels and AVPR2 m RNA levels were positively correlated.2. This study suggested that copeptin and AVPR2 m RNA levels had no significant difference between the second and third groups.The copeptin levels of the second and third groups were higher than that of the first group and AVPR2 m RNA levels of the third group was higher than that of the first group which both had significant differences.The differences of AVPR2 m RNA levels of 1,2 groups were not statistically significant.3. The copeptin levels of the left main disease were the highest,and the differences were statistically significant compared with the single, double, triple lesions groups.Compared with the single lesion group and double lesions group, there were significant differences in the triple lesions group.The difference between the single lesion group and double lesions group were not statistically significant.The AVPR2 m RNA levels of the left main disease were the highest,and the differences were statistically significant compared with the single, double, triple lesions groups. There was no significant difference in the AVPR2 m RNA levels among the single, double,triple lesions groups.4. Areas under the ROC curves of the copeptin levels, AVPR2 m RNA levels and c Tn I levels were 0.855(95% confidence interval,0.792-0.918), 0.779(95% confidence interval, 0704-0853), 0.964(95% confidence interval,0.936-0.991). Combined Logistic regression analysis and ROC curve, we could know that AVPR2 m RNA levels were not included in the equation.Areas under the ROC curve of the combination of the copeptin levels and c Tn I levels was 0.972(95% confidence interval, 0.938-0.996).In conclusion:1. The copeptin levels, AVPR2 m RNA levels increased with the progress of coronary heart disease and reflected the severity to a certain extent.2.Copeptin levels and AVPR2 m RNA levels were positively correlated.Combined detection of the copeptin levels and c Tn I levels can improve the sensitivity of AMI diagnosis and provide reference for the early diagnosis of AMI. |
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