Diagnostic Value Of STWEAK And MMP-9 In Serum Of Patients With NSTEMI

Coronary heart disease(CHD)is one of the most common cardiovascular diseases.In recent years,a large number of studies have confirmed that coronary heart disease is a chronic inflammatory disease,and its formation is the result of inflammation-fiber proliferative reaction of coronary artery[1].A large amount of growth factors and inflammatory mediators can aggravate the inflammatory reaction,pro mote the growth of the plaq ue,and lead to the formation of coro nary heart disease.Tumor necrosis factor-like weiler of appotosis(TWEAK),as a member of the superfamily of tumor necrosis factor,can play a variety of biological functions including apoptosis,migration and proliferation through the interaction with the receptor-fibroblast growth factor inducing early reaction protein 14(Fn14).Differentiation,angiogenesis and inflammation[2,3].It plays an important role in the pathophysiology of cardiovascular diseases such as coronary heart disease,heart failure and myocardial infarction.For a long timis e,it is believed that the receptor-fib rob last-inducing factor 14(Fn14)the only receptor for TWEAK,and Moreno JA et al[4]report that it can also function through CD163.Matrix metalloprotease(MMPs)is a type of inflammatory factor,which belongs to the family of endogenous proteases,matrix metallopro tease 9(MMP-9)can degrade extracellular matrix.It is closely related to the formation and rupture of coronary atheromatous plaques and ventricular remodeling in coronary heart diseasebC[5,6].The concentration of sTWEAK and MMP-9 in patients with ST-elevation myocardial infarction(STEMI)was significantly higher in patients with STEMI and a negative correlation with the prognosis[7,8].However,the changes of serum in patients with acute no n-ST ele vatio n myocard ial infarction(NSTEMI)are still controversial.ObjectiveThe specificity and se nsitivity of sTW EAK and MMP-9 to NSTEMI in patie nts with NS TEMI and the diagno stic value of sTWEAK and MMP-9 in NSTEMI were discussed by detecting the difference of sTWEAK and MMP-9 in the serum of patients and healthy people.MethodsPatients with coronary heart disease(CHD)were selected from September 2017 to August 2018 in the Department of Cardiology,second affiliated Hospital of Shenyang Medical College.According to clinical manifestations,myocardial enzymes,electrocardiogram and coronary angiography or coronary CT confirmed stable angina pectoris(stable angina pectoris,There were 30 patients,62 patients with unstable angina pectoris,53 patients with acute non-elevation myocardial infarction.The control group(36 persons)diagnosed as healthy by physical examination in the physical examination center.Among them,NSTEMI was the experimental group and the other groups were the control group.Collect and arrange the basic clinical data(including number,age,sex,blood pressure,blood lipid,blood sugar,body mass index,etc.)of the selected patient.The concentration of sTWEAK,MMP-9 in serum was determined by enzyme-linked immunosorbent assay(ELISA).Other biochemical blood was sent to the Department of Laboratory,the second affiliated Hospital of Shenyang Medical College,and the laboratory equipment was tested regularly according to the requirements,which considered the test results to be reliable.SPSS22.0 was used for statistical analysis,the basic clinical data of each gro up were compared,the concentration of sTWEAK,MMP-9,cTnI,Hs-CRP in serum was compared,the correlation between sTWEAK,MMP-9 and cTnl and Hs-CRP in serum was analyzed,and the serum sTWEAK,was analyzed.Diagnostic value of MMP-9 concentration in NSTEMI.Results1.There was no significant difference in MMP-9,sTWEAK,hs-CRP and Tnl between healthy control group and SAP group(P>0.05).The troponin I of the NSTEMI group was significantly higher than that of the other three groups(P<0 05),but there was no significant difference between the other three groups(P>0 05).The concentration of sTWEAK,MMP-9,hs-CRP in NSTEMI group and UAP group was significantly higher than that in healthy control group and SAP group(P<0.05),NSTEMI).The concentration of MMP-9,hs-CRP,TnI was significantly higher in NSTEMI group than that in UAP group(P<0 05).2.There was a positive correlation between serum sTWEAK and MMP-9 concentration in NSTEMI group(r = 0.528,P<0.001).There was a positive correlation between serum sTWEAK and cTnI(r=0.704,P<0.001),and a positive correlation between serum MMP-9 and cTnI(r= 0.622,P<0.001).There was no correlation between serum s TWEAK and Hs-CRP(r=0.195,P>0.05),but there was a positive correlation between serum MMP-9 and Hs-CRP(r=0.362,P<0.05).3.The critical value for diagnosis of NSTEMI by sTWEAK was 35.25 pg/ml,the sensitivity was 78.6%,the specificity for 66.7%.MMP-9 was 535.8 ug/l,the sensitivity was 77.9%and the specificity was 72.2%.It has high predictive value for NSTEMI.Conclusion1.In NSTEMI,sTW EAK is positively related to the concentration of MMP-9,serum sTWEAK and MMP-9 were positively correlated with cTnI,MMP-9 was positively correlated with Hs-CRP,and serum sTWEAK and Hs-CRP were not correlated.2.The expression of sTWEAK,MMP-9 in NSTEMI group was significantly higher than that in other groups,which had high diagnostic value for NSTEMI.