The Correlation Between Serum Clusterin Level And Coronary Artery Stenosis In Patients With Acute Coronary Syndrome

Objective: The aim of this study was to investigate the changes of clusterin protein level in serum of patients with acute coronary syndrome and its correlation with the degree of coronary artery stenosis.Methods: We select 182 patients who underwent coronary angiography in the Second Hospital of Hebei Medical University from January 2018 to December 2018.According to the symptoms and the coronary angiography results,the patients were divided into acute coronary syndrome group and normal control group.The ACS group was further divided into ST-segment elevation myoc-ardial infarction group and non-ST-segment elevation ACS group according to clinical manifestations and auxiliary examination.The ACS group was also divided into low-risk group,middle-risk group and high-risk group according to the syntax score.The general clinical data and biochemical indexes of the subjects were collected and the serum levels of CLU were detected using elisa.The data were analyzed with statistical software of SPSS 22.0.Results:1.The general clinical data: there were no statistical differences among the CON group,STEMI group and NSTEACS group in age,sex ratio,BMI,history of hypertension,history of diabetes,smoking history(P>0.05).Comparison of laboratory examination indexes: triglycerides,total cholesterol,high-density lipoprotein,low-density lipoprotein,creatinine,uric acid and other biochemical indexes were compared among the three groups,the differences were not statistically significant(P>0.05),The difference of hypersensitive c-reactive protein was statistically significant(P< 0.05).2.The serum CLU levels among the different groups: ACS group was higher than CON group(1.83±0.77mg/mLVS1.38±0.53mg/mL),and the difference was statistically significant(P< 0.01).STEMI group was higher than CON group(1.85±0.89mg/ml vs.1.38±0.53mg/mL,P<0.05),and NSTEACS group was higher than CON group(1.83±0.72mg/mL vs.1.38± 0.53mg/mL,P<0.01),the differences were statistically significant.There was no significant difference between NSTEACS group and STEMI group(1.83± 0.72mg/mL vs.1.85±0.89mg/mL,P> 0.05).3.The analysis of serum CLU levels and indicators: The serum CLU levels had positive correlation with BMI(r= 0.49,P<0.01),and the difference was statistically significant.There was positive correlation with SYNTAX score(r=0.47,P<0.01)and the difference was statistically significant.4.The correlation between serum clusterin level and coronary artery severity in patients with acute coronary syndromeAccording to the SYNTAX score:the serum level of the high-risk group was significantly higher than that of the low-risk group(2.50±0.62mg/mLvs.1.57±0.77mg/mL,P<0.01)and the middle-risk group(2.50±0.62mg/mLvs.2.02±0.54mg/mL,P<0.05),and the difference was statistically significant.The serum level of the middle-risk group was higher than that of the low-risk group(2.02±0.54mg/mL vs.1.57±0.77mg/mL,P<0.01),the difference was statistically significant.5.The factors influencing the degree of coronary artery lesions: Through multiple linear regression analysis,SYNTAX score as the dependent variable;gender,age,history of hypertension,history of diabetes,history of smoking,TG,CHOL,HDL-C,LDL-C,Cr,hs-CRP and CLU as independent variables,The results show that there was a linear regression relationship between CLU and SYNTAX score.The CLU level was independent of gender,age,BMI and other factors.Conclusions: The serum CLU level was significantly increased in the ACS group,which was positively correlated with SYNTAX score,suggesting that the CLU might play a promoting effect in the occurrence and development of ACS,and might become an important indicator in predicting the severity of coronary artery lesions.