| Objective:This study is to investigate the relationship between cathepsin S(Cat S)and cathepsin K(Cat K)levels with acute coronary syndrome(ACS).Methods:1.300 patients admitted to the hospital for coronary angiography due to chest pain were divided into a control group(52 cases)and an ACS group(248 cases)according to clinical symptoms and related examination results.And then ACS group was divided into two subgroups: unstable angina pectoris group(UA Group,193 patients)and acute myocardial infarction group(AMI group,55 patients).Collect general information and clinical indicators of patients at admission;2.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum Cat S and Cat K levels in each group of patients.Multivariate Logistic regression analysis was used to explore possible risk factors for ACS.Pearson analysis was used to analyze serum Cat S and Cat K levels with ACS relevance;3.According to the TIMI(The Thrombolysis in Myocardial Infarction)risk score,patients in the ACS group were divided into low-risk group(25 cases),intermediate-risk group(182 cases),and high-risk group(41 cases).Correlation of serum Cat S and Cat K levels with TIMI risk score were analyzed by single factor analysis of variance;4.Patients were divided into MACE group(34 cases)and non-MACE group(214 cases)according to whether major adverse cardiovascular events(MACE)occurred within 1 year of follow-up.Multivariate Logistic regression was used to analyze possible risk factors for MACE;5.The Spearman correlation coefficient was used to analyze the correlation between serum Cat S and Cat K levels with the occurrence of ACS and MACE and TIMI risk score.Results:1.The levels of Cat S and Cat K in the ACS group were significantly higher than those in the control group(P<0.001),the AMI group was significantly higher than the UA group(P<0.001),the UA group was significantly higher than the control group(P<0.001),and the serum in the MACE group was significantly higher.Cat S and Cat K levels were also significantly higher than those in the non-MACE group(P<0.05);2.Multivariate Logistic regression analysis showed that smoking,Cat S,and Cat K were independent risk factors for ACS(OR = 16.592,1.010,1.012,P<0.05).Cat S and Cat K were independent risk factors for MACE(OR = 1.003,1.005,P<0.001);3.The receiver operating characteristic(ROC)curve analysis showed that the area under the Cat S curve was 0.837(P<0.001,95% CI: 0.774-0.900),and the area under the Cat K curve was 0.852(P<0.001,95% CI: 0.794-0.910);4.Correlation analysis showed that serum Cat S and Cat K levels were positively correlated with Gensini scores(Cat S R=0.70,P<0.001;Cat K R=0.56,P<0.001),and negatively correlated with left ventricular ejection fraction(LVEF)(Cat S R=-0.66,P<0.001;Cat K R=-0.54,P<0.001),which was positively correlated with the TIMI risk score(P<0.05).There was no significant correlation between serum Cat S and Car K levels(R=0.40,P<0.001);5.The Spearman correlation coefficient showed that serum Cat S and Cat K levels were positively correlated with the occurrence of ACS and MACE(P<0.001).Cat K was stronger than Cat S(Cat S rho: 0.442;Cat K rho: 0.462);Cat S was stronger than Cat K in the occurrence of MACE(Cat S rho: 0.505,Cat K rho: 0.290);Serum Cat S and Cat K levels were positively correlated with TIMI risk score(P<0.001),Cat S is more relevant than Cat K(Cat S rho: 0.227;Cat K rho: 0.116).Conclusion:1.Serum Cat S and Cat K levels are significantly related to the occurrence and development of ACS;smoking,Cat S and Cat K are independent risk factors for ACS;serum Cat K levels have a higher predictive value for ACS than Cat S;Cat S and Cat K levels were significantly correlated with the severity of coronary lesions;2.Serum Cat S and Cat K levels have a certain predictive value for the prognosis of ACS;the correlation between Cat S and TIMT score is slightly higher than Cat K,and the correlation between Cat S and MACE is higher than Cat K. |
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