The Changes Of Sphingosine-1-Phosphate In Patients With Non-ST Segment Elevation Acute Coronary Syndrome And Its Correlation With GRACE Score

Objective: The aim of this study was to observe the changes in serum levels of sphingosine-1-phosphate(S1P),HDL-bound sphingosine-1-phosphate(HDL-S1P)in the non-ST-segment elevation acute coronary syndrome(NSTACS)group,and to analyze its correlation with GRACE Score.Methods: To collect 142 inpatients with coronary artery disease in the coronary heart disease ward of the Second Hospital of Dalian Medical University from November 2018 to December 2019,including 36 patients in the non ST segment elevation acute myocardial infarction(NSTEMI)group and 58 patients in the unstable angina pectoris(UA)group.According to the selection criteria and exclusion criteria,the patients with normal coronary angiography in 142 patients were set up as control group,a total of 48 patients.General clinical data of the selected subjects were collected,including: sex,age,heart rate,blood pressure,history of hypertension,history of smoking,and post-hospital electrocardiogram.Fasting venous blood was collected the next day after admission to detect WBC?RBC?PLT?TC?TG?HDL-C?LDL-C?AST?ALT?Bun?Cr?UA?Alb and c TNI levels.Serum S1P?HDL-S1 P levels were quantified by ELISA method.GRACE score was evaluated to assess the severity of illness.According to the results of coronary angiography,Gensini score was used to evaluate the severity of coronary stenosis.Results: 1.The S1 P level of NSTEMI group [2475.36(2193.13-2942.31)nmol/L]was significantly higher than that of control group [999.40(811.47-1375.77),and the difference was statistically significant.The S1 P level [1831.18(1354.06-2313.22)nmol/ L] in the UA group was significantly higher than the S1 P level [999.40(811.47-1375.77)nmol / L] in the control group,and the difference was statistically significant.The S1 P level of NSTEMI group was higher than that of UA group,the difference was statistically significant.And the HDL-S1 P level was not statistically significant among the three groups.2.Serum S1 P was positively correlated with Cr and c TNI,negatively correlated with Alb,HDL-C,and Apo A,and not significantly correlated with WBC,Hb,PLT,ALT,AST,Bun,UA,TC,TG,LDL-C,and Apo B.There was no significant correlation between serum HDL-S1 P and WBC,Hb,PLT,c TNI,ALT,AST,Alb,Bun,Cr,UA,TC,TG,HDL-C,LDL-C,Apo A and Apo B.3.Serum S1 P level was positively correlated with GRACE score and no significant correlation with Gensini score in the group.There was no significant correlation between serum HDL-S1 P level and Gensini score and GRACE score.4.There was no significant correlation between S1 P and HDL-S1 P in all selected patients.5.Multiple linear regression analysis showed that in the NSTACS group,S1 P,age,and Cr were positively correlated with GRACE scores,and albumin was negatively correlated with GRACE scores.Conclusion: 1.NSTACS serum S1 P levels of patients increased significantly,HDL-S1 P was no obvious change in NSTACS patients,S1 P may play a role in the occurrence and development of NSTACS;2.The level of S1 P in NSTEMI patients was significantly higher than that in UA patients.Multiple linear regression showed that S1 P was positively correlated with GRACE score,but there was no significant correlation with Gensini score.HDL-S1 P had no correlation with Gensini score and GRACE score.S1 P may be used as a reference index for the severity of NSTACS patients,but it cannot predict coronary disease Degree of stenosis.