| Objective: To investigate the statistical differences and clinical significance of serum PD-1 levels in patients with coronary heart disease,especially acute ST-segment elevation myocardial infarction(STEMI)and negative control group,To investigate the value of serum PD-1 in the prediction of STEMI,the severity of coronary artery lesion and the degree of cardiac function injury,To assess the effect of PD-1 levels on major adverse cardiac events(MACE)in patients with STEMI.Methods: A total of 88 patients from February 2015 to January 2016 in the Soviet Union from The Second Hospital Affiliated to Soochow University as a research object,Among them,45 patients with STEMI,with 13 patients with stable angina pectoris and 30 patients with negative control group.Blood samples were collected 24 hours before admission and serum PD-1 levels were measured by enzyme-linked immunosorbent assay(ELISA).The correlation between LDL-c and PD-1 before CRP and non-taking statin was recorded within 24 hours of STEMI patients,Dynamic monitoring of patients with troponin T(cTnT),take the peak as a myocardial injury index,Records of patients with heart disease within 7 days of ultra-left ventricular ejection fraction(EF)results,as a patient with cardiac dysfunction indicators.According to the results of coronary angiography coronary heart disease severity(Gensini)score,STECI patients were followed up for 12 months to record the occurrence of MACE.Results:1.The level of PD-1 in STEMI group(254.06 ± 29.67 pg / ml)and stable angina pectoris group(255.48 ± 29.23 pg / ml)was significantly lower than control group(335.06 ± 51.98 pg / ml).There was no significant difference between STEMI group and stable angina pectoris group(254.06 ± 29.67 vs 255.48 ± 29.23 pg / ml).2.The correlation of serum PD-1 level with CRP,LDL-c and cTnT in STEMI group was analyzed.,Indicate the levels of serum PD-1 were positively correlated with CRP(r = 0.608,P <0.001)and LDL-c(r = 0.521,P <0.001).There was no significant correlation between serum PD-1 concentration and cTnT concentration(r=0.002,P=0.988).3.In the STEMI group,the serum PD-1 levels were not significantly different between the EF < 50% group(247.90±30.45 pg/ml)and EF > 50%(257.81±29.10 pg/ml),Serum PD-1 levels in Gensini integral < 30 >(241.78±33.69 pg/ml),30 < Gensini integral < 90 group(261±25.53 pg/ml)and Gensini integral > 90 groups(250.10±32.69 pg/ml)were not statistically different.4.Multivariate logistic regression analysis showed that,Smoking(OR=4.549,95% CI:1.109~18.659,P < 0.05),sex(OR=10.785,95% CI:1.629~71.376,P<0.05)and PD-1(OR=0.970,95%,CI:0.954~0.987,P < 0.001)were independent risk factors for STEMI.5.Through PD-1 level and STEMI incidence ROC curve,take cutoff point 277.54 pg/ml,The patients were divided into low PD-1 level group(n=33)and high PD-1 level group(n=12),The rate of MACE in patients with STEMI within 12 months of follow-up was significantly higher in the low level group than in the high level group(42.42%,VS 8.33%,P < 0.05).Multi factor Logistic regression analysis showed that the MACE event was performed,low-level PD-1(OR = 0.942,95% CI: 0.892~0,998,P <0.05)was a risk factor for MACE.Conclusions:1.Low serum level of PD-1 was an independent risk factor for STEMI.2.Serum PD-1 concentration in patients with STEMI was positively related to the concentration of CRP and LDL-c,Suggesting that PD-1 may play a key regulatory role in dyslipidemia and atherosclerotic plaque formation during inflammatory response.3.There was no correlation between PD-1 levels and troponin peak in patients with STEMI,and there was no significant difference between the different gensini,suggesting that there was no significant correlation between the severity of coronary lesion and the severity of coronary artery disease.4.Low level PD-1 is a risk factor for the occurrence of MACE events in STEMI patients. |
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