Relationship Among Parathyroid Hormone And Coronray Artery Stenosis And Short Term Prognosis In Patients With Coronary Heart Disease

Objective:To research the role of parathyroid hormone(PTH)in the development of coronary heart disease(CHD)and the connection with coronray artery stenosis.To explore whether PTH is related to short-term prognosis of CHD.Methods:A total of 143 patients who aged thirty-six to seventy-nine and diagnosed with CHD by coronary angiography were included in our hospital of cardiology department between January 2016 and January 2017,107 age-matched normal controls were recruited.Their coronray stenosis were estimated according Gensini score and PTH level were measured by double antibodies sandwich.General information and PTH level were compared between CHD group and normal control group.CHD patients were divided into three groups according electrocardiogram examination and symptoms and so on,including SAP group(stable angina pectoris group,n=40),UAP group(unstable angina pectoris group,n=42),AMI group(acute myocardial infarction group,n=61).Then general information and PTH level were compared between three groups.Also were divided into three groups according the number of vasculer lesions,including A1 group(single lesion vessel,n=40),A2 group(double lesion vessel,n=51),A3 group(three lesion vessel,n=52);divided into four groups according Gensini score,including B1 group(score?18.5,n=49),B2 group(18.5<score?45.0,n=53),B3 group(45.0<score?71.5,n=20),B4 group(score>71.5,n=21);then groups of general information and PTH level were compared,whether PTH was associated with the degree of coronary stenosis were investigated.Further multivariate logistic regression analysis were used to study whether PTH was a risk factor in CHD.Also CHD patients were observed for 1 year and classified into MACE group and non-MACE group according recorded major adverse cardiovascular events to compare the PTH level.Further were divided into four groups according PTH level,including Q1 group(<33.0pg/ml,n=31),Q2 group(33.0?PTH<44.2pg/ml,n=22),Q3 group(44.2?PTH<65.0pg/ml,n=40),Q4 group(?65.0pg/ml,n=50).The connection between PTH and short-term prognosis of CHD were analysised by Kaplan-Meier survival curve and COX regression analysis.Results:The proportion of smoking,diabetes,TC,LDL-C,Fib,HbAIc and PTH level in CHD group were obviously higher than normal control group(P<0.05,P<0.01,P<0.001).The PTH level was increased significantly with the progression of CHD(P<0.001),performanced SAP<UAP<AMI group(P<0.001).Also SAP group was statistically significant with UAP and AMI groups(all P<0.001),but there was no statistically significant between AMI and UAP groups(P>0.05).The PTH level were also increased significantly with the number of vasculer lesions(P<0.001),performanced A1<A2<A3 group(P<0.05).Only A1 group was statistically significant with A3 group(P<0.01).The PTH level were also increased significantly with Gensini score level(P<0.01),performanced B1<B2<B3<B4 group(P<0.01).B1and B2 groups were statistically significant with B3 and B4 groups(all P?0.01,P?0.001).Also B3 group was statistically significant with B4 group(P<0.01),but there was no statistically significant between B1 and B2 group(P>0.05).The PTH level were positivily ralated with the number of vasculer lesions(r_s=0.232,P<0.001)and gensini score(r_s=0.428,P<0.001)in Spearman's correlation.Multivariate logistic regression analysis showed that PTH was a risk factor in CHD patients.The PTH standard in MACE group were obviously rasied than non-MACE group during followed up(P<0.001).Kaplan-Meier survival curve showed that the incidence of MACE was increased with the PTH level in CHD patients.Log-rank test showed that Q4 group was higher than Q3 group,Q2 group and Q1 group(P<0.001,P<0.001,P<0.001).But there was no statistically significant between other groups(P>0.05).Multivariate COX regression analysis showed that PTH(RR=1.011,95%CI1.005-1.017,P<0.001)and Gensini score(RR=1.018,95%CI 1.012-1.017,P<0.001)were risk factors for short-term prognosis of CHD.Conclusion:1.The PTH level in CHD group were obviously higher than normal control group.With the progression of CHD,the number of coronary artery lesions and the degree of coronary stenosis increased,PTH level gradually increased and positively correlated.PTH may plays an important role in the development of CHD.2.The PTH standard in MACE group were obviously higher than non-MACE group during followed up 1 year of CHD patients.Kaplan-Meier survival curve and log-rank test showed that the incidence of MACE was increased with the PTH level in CHD patients.Further more multivariate COX regression analysis showed that PTH and Gensini score were risk factors for short-term prognosis of CHD.So PTH may be associated with prognosis of CHD.