Analysis Of The Relationship Between Coronary Micro-vascular Angina And LP-PLA2 And Related Risk Factors

Objective:By measuring serum lipoprotein associated phospholipase A2 level in different populations,we analyzed its diagnostic value for microvascular angina pectoris,and analyzed the correlation between related risk factors and MVA.Methods:The selected 230 patients were admitted to our hospital department of cardiology with Precordial discomfort from October 2016 to December 2017.All patients were underwent coronary angiography.A treadmill exercise test or 12-lead ambulatory electrocardiogram was performed on patients with no significant coronary angiographic abnormalities(<20% coronary artery stenosis).In patients with no obvious abnormalities in coronary angiography,a repeated treadmill exercise will be conducted.The control group was composed of 30 patients with normal coronary angiography and negative treadmill exercise test or holter monitoring.Select 110 patients with normal coronary angiography and positive treadmill exercise test or 12-lead electrocardiogram examination(ST-segment depression or horizontal depression ?0.1mv)as microvascular angina group.Patients were divided into 60 cases of microvascular angina pectoris with hypertension and 50 patients with simple microvascular angina according to the history of hypertension.The clinical data and related biochemical indicators of all the subjects were collected.Compare the level difference of LP-PLA2 between each group.Analysis of the influence factors of microvascular angina pectoris by single factor and multiple factor Logistic regression.After eliminating confounding factors,the correlation between the level of LP-PLA2 and coronary microvascular angina was determined by the ROCcurve.Results:(1)Compared with the control group,the level of LP-PLA2 in the simple MVA group was significantly higher[(173.38±103.73)ng/ml vs(95.07±41.46)ng/ml,P<0.05];The level of LP-PLA2 in the MVA combined with hypertension group was significantly higher than that in the simple MVA group[(223.33±120.78)ng/ml vs(173.38±103.73)ng/ml,P<0.05].(2)The results of single factor analysis show that LP-PLA2,hsCRP and Hcy are all factors affecting MVA.(3)The multivariate Logistic regression analysis showed that LP-PLA2 and hsCRP were risk factors for MVA,including LP-PLA2(OR=1.016,95%CI:1.005-1.027,P =0.004),hs-CRP(OR=4.009,95%CI:1.520-10.570,and hs-CRP.(4)The ROC curve showed that LP-PLA2 has a high accuracy in diagnosing MVA(the area under the curve is 0.780,the corresponding significance is 0,the cut-off point is120.435,the sensitivity is 0.600,the specificity is 0.833).HsCRP and Hcy have a general accuracy in diagnosing MVA.Conclusion:(1)The level of LP-PLA2 in MVA patients was higher than that in the control group,indicating that LP-PLA2 was involved in the pathogenesis of MVA;(2)LP-PLA2,hsCRP,and HCY are the factors affecting MVA;(3)LP-PLA2 and hsCRP were all risk factors for MVA;(4)LP-PLA2 is of great significance for the diagnosis of MVA.