Study On Relationship Between LOX-1,CX3CR1 With CHD And ISR After PCI

Objective: To explore the changes of lectin-like oxidized low- density lipoprotein(ox-LDL) receptor-1(LOX-1) and CX3 C chemokine receptor 1(CX3CR1)with coronary artery stenosis disease before percutaneous coronary intervention(PCI) and 1-3, 30-60 days after PCI and its outcomes. Investigate the association of LOX-1 and CX3CR1 with restenosis after PCI. Evaluate the association of CX3CR1 V249 I and T280 M with coronary heart disease(CHD) and myocardial infarction(MI) by Meta analysis method.Methods: A total of 80 patients with coronary artery stenosis which had received PCI were served as case group. Forty healthy volunteers in same time period were selected as control group. LOX-1 and CX3CR1 were measured before PCI and 1-3, 30-60 days after PCI in patients of case group and in volunteers of control group. The general information and laboratory parameters were recorded in the 2 groups. All of the data were analyzed by SPSS 17.0 software. In the study of the association LOX-1 and CX3CR1 with restenosis after PCI, to selected 100 restenosis patients were diagnosed by CAG after PCI from Cardiology of Tianjin Teda International Cardiovascular Hospital from January 2010 to November 2013, as restenosis group; 87 without restenosis patients were diagnosed by GAG in the same period as no restenosis group; the patients who were treatment with PCI postoperative 1-7 days in the same period as control group. General information and laboratory parameters were recorded and the levels of LOX-1, CX3CR1, D-dimer, Urea(UA), Creatinine(CREA) were measured in the three groups. Compared the indicators of each group, correlation analysis was used for LOX-1, CX3CR1 and Gensini and various variables. The course of major adverse cardiac events(MACE) between the high LOX-1 level group and low LOX-1 level group of restenosis patients were analysed. Observe the level of LOX-1 after 1-7day PCI among the 31 restenosis patients and 51 no restenosis patients. In the study of the relationship between CX3CR1 gene polymorphism and CHD and MI by Meta analysis,we collected the literatures published at home and abroad, screened case-control study on CX3CR1-V249 I, T280 M and CHD(includingunstable angina, acute coronary syndrome), MI. Review manager 5.3 software for the forest figure, STATA 11 software was used for the funnel plot and the bias was assessed using the Egger method.Results: LOX-1 and CX3CR1 levels began to decline significantly in 1-3 days after PCI and two receptors significantly lower in 30-60 days post-PCI than that in before PCI and in control group respectively. Logistic regression and receiver operating characteristic(ROC) curve analysis showed that LOX-1 levels before PCI, level of LOX-1 in 1-3 days after PCI were risk factors of coronary artery stenosis lesion, there were some diagnostic efficiency of coronary artery stenosis lesion. Resthenosis group, non-resthenosis group and control group were compared, LOX-1: 3.88(2.66,4.98)ug/L, 6.84(4.13,8.49)ug/L, 7.61(5.38,10.20)ug/L, Z=65.966,P<0.001; CX3CR1: 3.60(3.15,3.99) ug/L, 4.11(3.78,4.41) ug/L, 6.00(5.70,6.20) ug/L, Z = 18.312, P <0.001; D-dimer:(3.12±1.31) mg/L,(3.39±1.49) mg/L,(3.76±2.12) mg/L, F=3.041,P <0.05; UA:(307.94±70.89) umol/L,(341.43±86.50) umol/L and(330.40±77.05) umol/L, F = 4.105, P <0.05; CREA:(66.16±16.69) umol/L,(68.98± 19.32) umol/L and( 72.06±18.03) umol/L, F = 3.151, P <0.05. There were no statistically significant correlation between LOX-1, CX3CR1 and Gensini score(R was 0.146, 0.011 respectively, P>0.05), LOX-1 positively related to UA(R = 0.284, P <0.01) and positively related to CREA(R = 0.316, P <0.01). LOX-1 was independent risk factor of restenosis after PCI. Comparison between the courses of MACE which developed of patients with high level LOX-1and that of patients with low level in restenosis group: [243.50(38.50,560.25)] days vs, [800.00(200.00,1391.00)] days, Z=2.227, P<0.05. Comparison between the levels and the courses of follow-up on 1-7 days after PCI in 31 patients which restenosis were developed and that in 51 patients which non-restenosis were developed in the follow-up period: LOX-1: [4.00(3.13,4.96)] ug/L vs [3.43(2.28,4.48) ug/L; courses of follow-up: [254.00(54.00,399.00)]days vs [263.00(162.00,937.00)]days,Z=2.085,P<0.05. In the study of the relationship between CHD and V249 I gene, a total of 12 articles were included. There were 5792 cases and 3773 controls. The results showedthat CX3CR1-V249 gene models of VI + II / VV, II / VV+VI, II/ VV and I / V can reduce the risk of CHD except the co-dominant model of VI / VV+II. In the study of the relationship between MI and V249 I gene, a total of 3 articles were included. There were 1641 cases and 1072 controls. The results showed that the recessive model of II / VV+VI and additive model of II /VV can reduce the risk of MI. In the study of the relationship between CHD and T280 M gene, a total of 12 articles were included. There were 5708 cases and 4144 controls. The results showed that the gene model of TM + MM / TT, TM / TT+MM, MM / TT and M / T but MM / TT+TM can reduce the risk of CHD. In the study of the relationship between MI and T280 M gene, a total of 3 articles were included. There were 1641 cases and 1072 controls. No effect of CX3CR1-T280 M gene polymorphisms on the risk of MI.Conclusion: LOX-1 and CX3CR1 are closely related to coronary artery stenosis lesion before PCI and after PCI, can be used for assessment of coronary artery lesions after PCI, and in this way come into play for prevention and treatment of coronary artery lesion after PCI. LOX-1, CX3CR1 may be involved in the process of lesions of PCI postoperative restenosis, LOX-1 was independent risk factor of restenosis of PCI postoperative. High level LOX-1 was related to the course of PCI postoperative to the occurrence of MACE. Higher level of LOX-1 of early postoperative restenosis has certain predictive effect on restenosis. The results of Meta analysis showed that CX3CR1-V249 gene polymorphism in VI + II / VV, II /VV+VI, II / VV and I / V could reduce the risk of CHD except the gene model of VI / VV+II. Both of II / VV+VI and II / VV can reduce the risk of MI. The polymorphism of CX3CR1-T280 M gene in TM + MM / TT, TM / TT+MM, MM / TT and M / T can reduce the risk of CHD except the gene model of MM / TT+TM. There is no relationshio between CX3CR1-T280 M gene polymorphisms and MI.