Detection Of Plasm A Annexin ? And Correlation Research In Patients With Acute Coronary Syndrome

Background: Acute coronary syndrome(ACS)is a serious clinical types of coronary artery disease,it includs unstable angina pectoris(UAP),non-ST-segment elevation myocardial infarction(NSTEMI)and ST segment elevation myocardial infarction(STEMI).As people's living standards improve,the incidence of ACS is rising.It has a high morbidity and mortality,and brought a heavy burden to social and family.In recent years,studies have shown that most pathogenesis of ACS have a direct relationship with intimal injury or plaque rupture,intimal injury often induce vascular spasm,on the basis of vasospasm may be accompanied by secondary thrombus formation,and plaque rupture can induce acute thrombosis.Its speed and type of thrombosis mainly depends on the degree of plaque rupture,plaque lipid under exposure to blood circulation and blood coagulation and fibrinolytic activity in vivo between state,etc.With the development of interventional treatment in our country and the standardization drugs application of the antiplatelet and anticoagulant,reduces the incidence of ACS patients with cardiovascular adverse events greatly.But it is hard to master the amount of blood atheromatous plaque and clots in the actual clinical work load,often prone to all kinds of complications due to excessive or insufficient treatment.annexin ? is a calcium ion which depends on one of the members of the family of phospholipids in combination with Annexin protein,it has a close relationship with rupture of unstable atherosclerotic plaquesthe and the formation of thrombosis,it is a hotspot in the research of thrombosis n recent years.Through the detection the levels of plasma annexin ? in patients with coronary heart disease and normal control group,This research is intended to explore the relationship between plasma Annexin V level and cardiovascular risk factors as fibrinogen,D-dimer,platelet activity and the scope of coronary artery stenosis in ACS patients,and try to assess predictive value of annexin?in acute coronary syndrome and the risk degree of ACS.Objective: Through the detection the levels of plasma annexi?in patients of ACS,SAP and normal control group which are admitted to hospital,This research is intended to explore the relationship between plasma Annexin V level and cardiovascular risk factors as fibrinogen,D-dimer,platelet activity and the scope of coronary artery stenosis in ACS patients.Methods: Select 156 patients who were diagnosis of CHD and successful examined by coronary angiography in our hospital and the 1st affiliated hospital of bengbu medical college from December 2014 to November 2014.These patients are divided into ACS group(N=88),SAP group(N=36)and normalcontrol group(N=32)According to the results of coronary angiography and modified Gensini score,the ACS patients can be divided into mild lesion group,moderate lesion and severe lesion group.all groups of patients are detected the level of plasma annexin?and platelet activity of by using flow cytometry instrument and the level of fibrinogen(FIB)and D-dimer(D-D)by using immunofluorescence method determination.The measurement data were expressed as x±s or M.The SPSS 17.0 software was used for statistical analysis.The two side P value<0.05 was considered statistically significant.Results:(1)The diffenences of expression rate of annexin?in acute coronary syndrome group compared with stable angina pectoris group and normal control group were statistically significant(F = 10.534,P = 0.024,0.000),but stable angina group compared with normal control group,there was no statistically significant difference(F = 10.534,P = 10.534).(2)Logistic regression analysis had showed that Annexin?was associated with ACS independently,and the risk factors influencing the ACS from large to small is respectively:annexin V(OR=2.669),PMAR(OR=2.240),diabetes(OR=2.098),hypertension(OR=1.821),LDL-C(OR=1.502),smoking(OR=1.346),FIB(OR=1.039),hs-CRP(OR=1.026),D-D(OR=1.011).(3)When the area under the ROC curve(AUC)was 0.610,the cut-off point is 25.15%,the sensitivity and specificity of diagnosis of ACS are 50.0%and 65.2%.(4)The level of plasma annexin?in ACS group has no obvious correlation with coronary heart disease risk factors such as age,gender,MBI,TC,TG,hs-CRP,HDL-C,LDL-C,Cr,FPG,Hb A1c(P>0.05),there was a positive correlation with plasma FIB(r=0.468,P=0.047),D-D(r=0.451,P=0.040),platelet maximum aggregation rate(PMAR)(r=0.531,P=0.010),smoking history(r=0.510,P=0.510),hypertension(r=0.506,P=0.012),diabetes(r=0.493,P=0.026).(5)The level of plasma annexin?were related to increasing coronary vessel disease extent in patients with ACS(P=0.010).and there was statistically significant difference among single,double and mutivessel coronary atery disease group(F=5.25,P=0.007),with the number of diseased coronary vessel increasing,the level of plasma annexin?were elevating.Conclousion:(1)The level of plasma annexin ? may partly reflect the degree of coronary artery lesions of ACS patients.It is of clinical significance for judging value of acute coronary syndrome and the risk degree of it.(2)The level of plasma annexin?in patients with ACS are not correlated with CHD risk factor such as age,gender,body mass,dyslipidemia,kidney and other indicators.It has a positive correlation with diabetes,hypertension,smoking,FIB,D-D and PMAR.