Correlation Research Of Cystatin-c And Fibrinogen With Acute Coronary Syndrome

Objectives:In recent years,the morbidity and mortality of coronary heart disease showed a rising trend year by year,and has become a great threats to people's life and health.With deepened research in mechanism of coronary heart disease,the association of cystatin-c(Cys-c)and fibrinogen(Fib)with coronary heart disease has been confirmed,but research of combining these two risk factors to evaluate the severity of coronary heart disease still lacked.The purpose of this study is to explore the correlation of cystatin-c(Cys-c)and fibrinogen(Fib)with the severity of coronary artery stenosis and the risk of acute coronary syndrome(ACS)in patients with ACS,which in order to provide certain reference for the evaluation of the sevierity of ACS in the early stage in clinical.Methods:A total of 303 consecutive patients with coronary angiography came from the cardiovascular department of The Second Affiliated Hospital of Fujian Medical University from October 2015 to December 2016 were selected,consisting of 179 patients with ACS(including 112 patients with unstable angina pectoris(UAP)and 67 patients with acute myocardial infarction(AMI))and 75 patients with stable angina pectoris(SAP)and 49 patients without coronary artery stenosis.the SAP group and the normal group were set as the control group in this study.The general clinical data,Cys-c and Fib were recorded for comparing the differences among groups.In ACS group,using the gesini scores to evaluate the sevierity of coronary artery stenosis,and using the globle registry of acute coronary event(Grace)scores to evaluate the risk of acute coronary syndrome.Analyzing the correlation of cystatin-c and fibrinogen with the severity of coronary artery lesions and the risk of acute coronary syndrome in patients with ACS respectively,and assessing the capability of joint detection of Cys-c and Fib to evaluate the severity of acute coronary disease.Results:1.There are statistical differences in age,smoking history,hypertension history and carotid artery intima-media thickness(IMT)among normal group,SAP group,UAP group and AMI group(P<0.05),and there are not statistical differences in sex ratio,diabetes history,body mass index(BMI),uric acid(UA),low density lipoprotein cholester(LDL-c),mean platelet volume(MPV)and creatinine clearance rate(Ccr)(P>0.05).2.The plasma FIB levels were obviously higher in AMI group than UAP group,SAP group and normal group(P<0.05),also significantily higher in UAP group than normal group(P<0.05).While UAP group was higher than SAP group,but the difference was not statistically significant(P>0.05).3.The serum Cys-c levels were obviously higher in UAP group than AMI group,SAP group and normal group(P<0.05),AMI group was also significantly higher than normal group(P<0.05).AMI group compared with SAP group,SAP group compared with normal group,the differences in the serum Cys-c levels all not have statistically significance(P>0.05).4.The correlation analysis in ACS group showed that Cys-c and Fib had a significantly positive correlation with Gesini scores(P<0.01),R=0.294,0.328,respectively.And when joint detected Cys-c and Fib,the correlation coefficient with Gesini scores reached to 0.352(P<0.01).5.In ACS group,setting the Gesini scores as the dependent variable for the multiple linear stepwise regression analysis,we found that Fib and Cys-c were significantly independently associated with the severity of coronary artery stenosis after adjusting for the influence of the gender,age,smoking history,diabetes history,carotid artery IMT,LDL-c and Ccr(P<0.05),Beta=0.138,0.185,respectively.Under the same conditions,when joint detected Cys-c and Fib,the Standardized Coefficent with Gesini scores reached to 0.278(P<0.001).6.The correlation analysis in ACS group showed that Cys-c and Fib had a significantly positive correlation with Grace scores(P<0.01),R=0.239,0.265,respectively.And when joint detected Cys-c and Fib,the correlation coefficient with Grace scores reached to 0.333(P<0.01).7.In ACS group,setting the Grace scores as the dependent variable for the multiple linear stepwise regression analysis,we found that Fib and Cys-c were significantly independently associated with the risk of ACS after adjusting for the influence of the BMI,carotid artery IMT(P < 0.01),Beta=0.201,0.185,respectively.Under the same conditions,when joint detected Cys-c and Fib,the Standardized Coefficent with Grace scores reached to 0.292(P<0.001).Conclusion:1.Cys-c and Fib levels were found much higher in patients with coronary artery stenosis.Among which,Cys-c levels were highest in UAP group followed by AMI and SAP group,and Fib levels went up with the aggravation of coronary heart disease in SAP group,UAP group and AMI group.2.Cys-c?Fib levels are independently correlated with Gesini scores and Grace scores respectively,joint detection of Cys-c and Fib could improve the capability to evaluate the severity of acute coronary disease.