The Relationship Between Fibrinogen,Lipoprotein A,Bilirubin And The Severity Of Coronary Artery Disease

Background:As we all know, the traditional risk factors of coronary heart disease(CHD)Include: higher age, hyperglycemia, hyperlipidemia, hypertension, smoking, obesity,insulin resistance and so on. But recent clinical studies found that CHD patients with no traditional risk factors has been going on. Accordingly, to study the emerging CHD risk factors has become a research hotspot. Although the relationship between plasma fibrinogen, lipoprotein a, serum bilirubin and CHD has been attracted much attention, there was a little respect to the report of effect of which on the severity of coronary artery degree.Objective:To determine the level of Fib LP(a), TBIL, DBIL, IBIL and study the relationship between those factors and the severity of coronary artery degree. So that we can provide a reference index for finding the early stage of CHD and better treatment.Methods:A total of 3514 suspected CHD patients in the cardiovascular department of the First Affiliated Hospital of Jilin University from January to June in 2014 were selected. There were 1297 cases, includes 771 males and 526 females, 28-97 years old(mean 58.1±9.82 year) met the inclusion criteria. All objects are excluded, acute or chronic infection, kidney and liver disease, blood system diseases, malignant tumor, autoimmune disease, abnormality of thyroidal function, thromboembolic disease, rheumatic heart disease, cardiomyopathy, myocarditis, received thrombolysis or take anticoagulant, and other drugs that can affect the observation index. Patients underwent selective coronary angiography(SCAG), and were recorded the general information and medical history. The next morning testedfasting blood lipids, blood coagulation detection routine, liver and renal function,blood glucose. patients with nomal coronary angiography were set as the control group(no CHD group), 389 cases altogether, 908 CHD group, and based on cornonary artery lesions count, they were divided into single group 348 cases,double branch lesions group 263 cases and three branch lesions group 297 cases. The data were processed with SPSS19.0.results:1. CHD group and non CHD group has significant differences in age, gender(male), hypertension, diabetes, smoking history, creatinine, triglyceride, cholesterol,low density lipoprotein, high density lipoprotein, fasting blood glucose(P<0.05).There was significant difference in age, diabetes mellitus, hyperlipidemia(P<0.05),in different coronary lesions, three branch lesions group>double branch lesions group>single group. Compared the level of blood lipid and blood glucose: three branch lesions group>double branch lesions group>single group. Multivariate Logistic regression analysis showed that there was correlation between male, age,hypertension, smoking history and CHD, which were the risk factors of CHD.2. Compared with non CHD group, the level of plasma Fib in CHD group was higher(P<0.01), as the number of diseased coronary artery increased, the plasma level of Fib improved accordingly(P<0.01). Correlation analysis showed that Fib and coronary lesions count was Positively related, R=0.189. Logistic regression analysis showed that after adjusting for age, gender, hypertension, smoking, high blood lipids and other factors, the correlation still exist.3. Compared with non CHD group, the level of LP(a) was higher(P<0.01), no matter men and women, as the number of diseased coronary artery increased, LP(a)level is gradually increased(P<0.05), Compared single group, nether double branch lesions group no normal group has significant difference(P>0.008); correlation analysis showed that LP(a) was positively correlated with the number of coronary artery lesions, r=0.095.4. Compared with non CHD group, the level of TBIL and DBIL were higher in CHD group, the difference was statistically significant(P<0.05). as the number of diseased coronary artery increased, the level of TBIL, DBIL, IBIL improved accordingly(P<0.05). Correlation analysis showed that TBIL, DBIL, IBIL and coronary lesions were negatively correlated. Multivariate Logistic regression analysis showed that DBIL was associated with the severity of coronary artery disease, which may be an independent risk factor for coronary heart disease.Conclusions:1. The level of plasma fibrinogen can reflect the severity of coronary artery disease, and it is also a simple monitoring index.2. whether male or female, as the number of diseased coronary artery increased,the level of LP(a) increased accordingly, showed that LP(a) is closely related with the severity of coronary artery disease.3. there is a negative correlation between serum Bilirubin level and coronary artery lesions, which may be a risk factor for CHD.