Relationship Between Serum Uric Acid,Cystatin C,Lipoprotein (a) And Severity Of Coronary Artery Lesion In Patients With Acute Coronary Syndrome

Objective:Objective To investigate the correlation between serum uric acid,cystatin C,plasma lipoprotein(a)and coronary artery lesions in patients with acute coronary syndrome.Methods:A total of 119 patients with chest discomfort as the main symptom in Cardiology Department of our hospital from December 2016 to December 2017 were retrospectively analyzed and the results of coronary angiography were divided into Thirty-six cases of single-vessel lesion,25 cases of double-vessel lesion,22 cases of multi-vessel disease and 39 cases of healthy control group were enrolled.The levels of serum uric acid,cystatin C,plasma lipoprotein(a)Coronary disease compared to the degree.Results:(1)There was no significant difference in gender,diabetes mellitus and low-density lipoprotein between acute coronary syndrome group and control group(P>0.05).Hypertension,smoking history and age were compared between the two groups,The difference was statistically significant(P<0.05);(2)The levels of serum uric acid,cystatin C and lipoprotein(a)in each subgroup of acute coronary syndrome were significantly higher than those in the control group(n=36),double-vessel disease group(n=25),multi-vessel disease group(n=22)The levels of uric acid,cystatin C,and lipoprotein(a)all increased in turn with statistical significance(P<0.05).(4)The correlation analysis showed that serum uric acid(r_s=0.553),cystatin C(r_s=0.536),and lipoprotein(a)(r_s=0.608)were positively correlated with the number of coronary artery lesions(P<0.01).(5)The receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of the three markers in ACS.The results showed that the area under the curve(AUC)of UA was 0.770,and when the cut-off value UA was351.5umol/L.The diagnostic sensitivity was 55.4%,the specificity was 97.2%,and the Yoden index was 0.526.The AUC of Cys C was 0.767,and when the cut-off value Cys C was 0.88 mg/L,the diagnostic sensitivity was 74.7%,the specificity was 69.4%,and the Yoden index was 0.441.The AUC of Lp(a)was 0.779,and when the cut-off value of Lp(a)was 220 mg/L,the diagnostic sensitivity was 61.4%and the specificity was 99.9%,and the Yoden index was 0.613.The AUC of the combined three indicators was 0.901,the diagnostic sensitivity was 75.9%,the specificity was 94.4%,and the Youden index was0.703.Conclusion:1.The levels of serum uric acid,cystatin C and plasma lipoprotein(a)are positively correlated with the degree of coronary artery lesion in patients with acute coronary syndrome.2.The clinical detection of serum UA,CysC,LP(a)levels may have some value in the diagnosis of acute coronary syndrome.The combination of the three is more reliable for the diagnosis of ACS;intervention of these indicators may help delay the process of ACS.