| Objective(1)The aim of this study is to investigate the affect factors of plasma lipoprotein-associated phospholipase A2(Lp-PLA2) and to demonstrate the relationship between Lp-PLA2 and Coronary Heart Disease(CHD). Furthermore, the prognostic value of Lp-PLA2 in patients with CHD was investigated during the short term follow up period.(2)Observe plasma levels of Lp-PLA2 in patients with different types of AF.And the relationship between and Left atrial diameter(LAD). Furthermore,to explore the mechanism of the effect of Lp-PLA2 in atrial fibrillation.Methods(1)Six hundred and sixteen two suspected CHD subjects wereenrolled in our study. Coronary angiography(CAG) was performed in these patients. According to the result of CAG, patients were divided into CHD group(n=460) and non-CHD group(n=202).The CHD patients were further divided into Percutaneous Coronary Intervention(PCI) group and non-PCI group in regards to their acceptance of PCI treatment. Similarly, The PCI patients were further divided into MACE group and non-MACE group according to the incidence of MACE within the thirty days of follow up after treatment. The plasma biochemical and Echocardiography indicators were measured. The basic clinical data in all groups and the follow up results in PCI group were recorded. The relationships between each variable with CHD, PCI and MACE were analyzed.(2)One hundred and twenty two atrial fibrillation patients was divided into three groups : paroxysmal atrial fibrillation group(A,n=38),persistent atrial fibrillation group(B,n=40) and permanent atrial fibrillation group(C,n=44),furthermore,selected forty-one sinus rhythm patients in random as control group(D,n=41).Recording the basic clinical data and testing indexes in all groups.Results(1) The plasma level of Lp-PLA2 was higher in CHD group than that in non-CHD group. It is also higher in PCI group than that in non-PCI group. And the best value for Lp-PLA2 to diagnosis CHD is 231.85ng/ml.(2) Logistic regression analysis revealed the following finding: ① the high plasma level of Lp-PLA2 is the independent risk factor to CHD and PCI treatment(OR1.066,95%CI1.051-1.082,OR 1.008,95%CI1.000-1.015, respectively).② Lp-PLA2( OR 1.003,95%CI1.017-1.048),LVEF(OR 1.864,95%CI0.751-1.995), remainder Gensini score(OR 1.079,95%CI1.062-1.097)and the ACS(OR 3.949,95%CI1.126-13.857)were the independent risk factor to the patients who accepted PCI treatment with MACE during a short term follow up period.(3) Lp-PLA2 was positively correlated with LDL-C(r=0.316). Remainder Gensini score(r=0.357), the number of culprit vessel(r=0.714),hs-CRP(r=0.488),Atherosclerosis index(r=0.261), glucose level(r=0.192)and fibrinogen(r=0.268) was negatively correlated with HDL-C(r=-0.250), CO2CP(r=-0.134)and WBC(r=-0.219.(4) Lp-PLA2 level in persistent and permanent group were significantly higher than paroxysmal and control groups(p<0.05). Hs-CRP levels in persistent and permanent groups were higher than paroxysmal and control groups.paroxysmal group was also higher than control group(p<0.05).LAD in permanent and persistent groups were greater than paroxysmal and control group(p<0.05).hs-CRP is positively correlated with LAD in paroxysmal group.(5) Hs-CRP and Lp-PLA2 are positive correlation with LAD both in persistent and permanent groups.Conclusion ① Plasma Lp-PLA2 level in CHD patients was significantly higher than that of control group. Plasma Lp-PLA2 level is also higher in PCI group than that in non-PCI group. Similar relationship was present in-between MACE and non-MACE group.② there were important predictive value of Lp-PLA2 in diagnosis and prognosis for the suspected CHD patients.③ Lp-PLA2 was positively correlated with LDL-C, remainder Gensini score, the number of culprit vessel,hs-CRP,Atherosclerosis index, glucose level and fibrinogen but it was negatively correlated with HDL-C, CO2 CP and WBC. |
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