| BackgroundCoronary atherosclerotic heart disease(CAD)is a group of clinical syndromes that based on coronary atherosclerosis,formation of lipid plaques,narrowing or occlusion of the lumen,and eventually leading to myocardial cell ischemia,hypoxia and even necrosis.Atherosclerosis is a complicated process.Currently,doctrine of Atherosclerosis generally accepted in the academic community is that after endothelial injury,lipid infiltration,inflammatory waterfalls erupt,and atheromatous plaques form.Studies have found that serum annexin A2,as an endogenous inhibitor of PCSK9,can regulate the level of low density lipoprotein cholesterol by inhibiting PCSK9's degradation of the LDL receptor.Serum annexin A2 acts as a "double-edged sword",which not only improves lipid metabolism,but also promotes inflammation.Whether it is related to coronary heart disease and lipid metabolism,and what kind of trend changes are still rarely reported.Therefore,we designed this clinical retrospective study to explore the clinical application value of serum annexin A2 in coronary heart disease and lipid metabolism.Research purposesThe purpose of this article is to investigate the differences in serum annexin A2 levels between patients with coronary heart disease and non-coronary heart disease patients,and to analyze their relationship with coronary heart disease types and coronary heart disease risk.At the same time,the relationship between serum annexin A2 and the number of coronary lesions and Gensini scores was analyzed.To investigate whether serum annexin A2 affects serum low-density lipoprotein cholesterol levels and provide new ideas and targets for secondary prevention and lipid-lowering treatment of patients with coronary heart disease.Research methodA total of 200 inpatients who were in the Department of Cardiovascular Medicine of Nanfang Hospital of Southern Medical University from August 2017 to August 2019 were collected and divided into coronary heart disease group and non-coronary heart disease group according to the results of coronary angiography.Patients with coronary heart disease are divided into stable angina pectoris group and acute coronary syndrome group according to clinical stability.The serum Annexin A2,MPO,and PON1 levels of the patients are detected,and their relationship with suffering from coronary heart disease,severity of coronary heart disease,coronary artery disease stenosis and LDL-C are analyzed.Result1.Compared with patients without coronary heart disease,patients with coronary heart disease have higher blood levels of Annexin A2?MPO?MPO/PON land lower levels of PON 1(P<0.05).The results of multivariate regression analysis show that high levels Annexin A2?MPO and low levels PON1 is an independent risk factor for the disease.2.Serum annexin A2 levels(2.43±1.66 vs 1.74±1.47 ng/L,P=0.013)?CRP levels(4.13 ± 8.73 vs 8.27 ± 14.24 mg/L,P=0.030)and neutrophil lymphocyte ratio(4.13 ±3.85 vs 2.56 ± 1.14,P=0.002)in patients with acute coronary syndrome was significantly higher than that in patients with stable angina pectoris.Analysis of the ROC curve showed that the area under the Annexin A2 combined with the CRP curve was the largest at 0.714(95%CI:0.625-0.803,P<0.001).3.There were no significant differences and trends in serum annexin A2 levels and MPO in each group of coronary lesions(P>0.05);Gensini scores had no significant correlation with serum annexin A2 levels(P>0.05).4.The level of Annexin A2 was 2.41 ± 1.72 ng/L in patients with coronary heart disease and diabetes,and 2.09 ± 1.57 ng/L in non-diabetic patients with coronary heart disease.There was no significant difference(P>0.05).Coronary heart disease subgroup analysis also suggest that serum Annexin A2 levels in patients with diabetes were Slightly higher than those without diabetes,but the differences were not statistically significant(P>0.05).5.Compared with patients with low Annexin A2 levels,serum cholesterol levels in patients with high Annexin A2 levels did not significantly decrease.(P>0.05)Conclusion1.Compared with patients without coronary heart disease,patients with coronary heart disease have higher blood levels of Annexin A2,MPO and lower levels of PON 1(P<0.05).The results of multivariate regression analysis show that Annexin A2,MPO and low levels PON1 is an independent risk factor for the disease.2.Serum annexin A2 levels(2.43 ± 1.66 vs 1.74±1.47 ng/L,P=0.013)?CRP levels(4.13 ± 8.73 vs 8.27±14.24 mg/L,P=0.030)and Neutrophil lymphocyte ratio(4.13± 3.85 vs 2.56 ± 1.14,P=0.002)in patients with acute coronary syndrome was significantly higher than that in patients with stable angina pectoris.Analysis of the ROC curve showed that the area under the Annexin A2 combined with the CRP curve was the largest at 0.714(95%CI:0.625-0.803,P<0.001).3.There was no significant correlation between serum Annexin A2 level and LDL-C level. |
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