| Background and Purpose Coronary heart disease(CHD)is a common clinical disease with coronary atherosclerosis as its pathological basis.In recent years,its incidence has become younger,and the morbidity and mortality have been significantly higher than before,which seriously affects the quality of human life.Non-ST-elevation acute coronary syndrome,an acute and critical illness in coronary heart disease,with acute onset?rapid disease progression and poor clinical prognosis,the primary diagnosis ?presumed coronary artery disease severity? and accuracy Stratification of risk is an important prerequisite for making clinical treatment decisions,which will also have an important impact on the patient's long-term prognosis.The purpose of this study was to determine serum lipoprotein-associated phospholipase A2(Lp-PLA2)levels and carotid intima-media thickness(c IMT)in patients with non-ST-segment elevation acute coronary syndrome.The relationship between cardiovascular risk stratification scores provides a basis for clinical management and treatment decision-making in patients with non-ST-segment elevation acute coronary syndromes.Materials and Methods A total of 142 patients with coronary heart disease admitted to the Department of Cardiology in our hospital were selected from September 2015 to December 2016,including 54 patients with unstable angina pectoris(UAP group),42 patients with non-ST elevation myocardial infarction(NSTEMI group),46 patients in the stable angina group(SAP group),and other 40 non-CHD patients during the same period were selected as the control group.(1)General data collection: age,gender,smoking history,current medical history,past history and pre-hospital medications.Body height and weight were measured at admission,body mass index was calculated,and vital signs such as heart rate and systolic blood pressure were measured;(2)Serum Lp-PLA2 level was determined by enzyme-linked immunosorbent assay(ELISA);(3)Carotid intima-media thickness was measured;(4)Coronary angiography was performed in all patients and SYNTAX scores were calculated for NSTE-ACS patients based on the results of the angiography;(5)GRACE risk scores and TIMI risk scores were calculated in NSTE-ACS patients for risk stratification;(6)Routine biochemical markers were determined: determination of hs-CRP,NT-Pro BNP,TG,TC,LDL-c,HDL-c and other indicators;(7)Statistical analysis SPSS21.0 software was used for statistical analysis.The difference was statistically significant at p<0.05.Results(1)There was no significant difference in age,sex,smoking history,body mass index,hypertension,diabetes,and triglyceride among the four groups(P>0.05);Compared with the control group,TC,LDL-c,hs-CRP and NT-Pro BNP were higher in three groups of coronary heart disease,however,HDL-c was lower(p<0.05).Compared with the SAP group,TC,LDL-c,hs-CRP,and NT-Pro BNP were higher in the NSTE-ACS group than,however,HDL-c was lower(p<0.05);(2)Compared with the control group,the levels of serum Lp-PLA2 and c IMT were higher in three groups of coronary heart disease(p<0.05).Compared with the SAP group,the levels of serum Lp-PLA2 and c IMT were higher in the NSTE-ACS group(p<0.05);(3)Serum Lp-PLA2 level and c IMT value were significantly correlated(r=0.635,p< 0.001);Among such traditional cardiovascular risk factors,serum Lp-PLA2 level was seriously correlated with smoking history,TG,TC,LDL-c,hs-CRP,NT-Pro BNP(p<0.05),and had a negative correlation with HDL-c level(p<0.05);The correlation analysis between c IMT and traditional cardiovascular risk factors showed that: c IMT value had a significant correlation with TC,LDL-c,NT-Pro BNP(p<0.05),and a negative correlation with HDL-c level(p<0.05).(4)The difference of serum Lp-PLA2 level and c IMT between the risk stratifications of SYNTAX scores,GRACE scores,TIMI scores were statistically significant(p<0.05).(5)Serum Lp-PLA2 level and c IMT value were positively correlated with SYNTAX score,GRACE score,and TIMI score(p<0.05).(6)Using NSTE-ACS as a dependent variable,Logistic regression analysis showed that TG,TC,LDL-c,hs-CRP,NT-Pro BNP,Lp-PLA2,and c IMT were risk factors for NSTE-ACS(p<0.05).Then took the above selected risk factors which served as independent variables into multivariate Logistic regression analysis.The results showed that NT-Pro BNP and Lp-PLA2 were independent predictors of risk for NSTE-ACS(p<0.01).conclusion 1.Serum levels of Lp-PLA2 level is positively associated with c IMT value,each of whom is related to traditional cardiovascular risk factors;2.Serum Lp-PLA2 levels and c IMT levels are positively correlated with SYNTAX cores,they could be used to predict coronary stenosis in patients with NSTE-ACS;3.Serum Lp-PLA2 levels and c IMT values are positively correlated with GRACE risk scores and TIMI risk scores,they could be used as predictors of risk stratification in NSTE-ACS patients.‘ 4.Serum Lp-PLA2 is an independent predictor of risk for NSTE-ACS. |
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