Research On The Relationship Between The Ratio Of Serum C1q And C3 And The Severity And Short-term Prognosis Of Coronary Heart Disease

Objective This study will analyze the relationship between C1q/C3 ratio and the severity of coronary heart disease(CHD),track the occurrence of end-point events within one year in patients with CHD,and explore its predictive value for major adverse cardiovascular events(MACE)in patients with CHD.Methods This research included patients who underwent coronary angiography(CAG)due to suspected CHD in the affiliated Hospital of Qingdao University from October 2018 to March 2019.The age,sex and other basic information of the patients were collected,and the venous blood of the patients was taken under fasting before CAG,and the levels of serum C1q,C3,blood glucose,blood lipids and other indexes were measured.According to the strict inclusion and exclusion criteria,a total of 170 patients were enrolled in this research,including CHD group(n =120)and control group(n = 50).The CHD group was divided into low score group(Gensini score?40)and high score group(Gensini score>40)according to Gensini score.According to the number of diseased branches of coronary artery,they were divided into single-vessel disease group,twovessel disease group and multi-vessel disease group.The differences between general clinical data among different groups were compared.Furthermore,Multiple Logistic regression analysis was used to clarify whether serum C1q level or C1q/C3 ratio was a protective factor for CHD.Finally,each patient with CHD was followed up for one year to follow up the occurrence of major adverse cardiovascular events(MACE),and the patients with CHD were divided into low ratio group(C1q/C3 ratio?142.85)and high ratio group(C1q/C3 ratio>142.85)according to the median of C1q/C3 ratio.The predictive value of C1q/C3 ratio on MACE in patients with CHD was analyzed by Kaplan-Meier curve.Result Compared with the control group,the CHD group had significant reductions in serum C1q and C1q/C3 ratio(P<0.05).According to the analysis of clinical subgroup,with the increase of the Gensini score,the serum C1q level and C1q/C3 ratio decreased gradually,and the control group > low score group > high score group.The C1q/C3 ratio was significantly different among the three groups,and the C1q level only showed statistical difference between the control group and the high score group(P<0.05).Similarly,with the increase of the number of coronary artery lesions,the serum C1q level and C1q/C3 ratio decreased gradually,single-vessel disease group > two-vessel disease group > multi-vessel disease group.The level of serum C1q in multi-vessel disease group was significantly different from that in single-vessel disease group and double-vessel disease group(P<0.05).There was no significant difference between single-vessel disease group and double-vessel disease group(P>0.05).However,the C1q/C3 ratio only showed statistical difference between the control group and the multi-vessel disease group(P <0.05).Pearson correlation analysis showed that there was a positive correlation between serum C1q and C3(r = 0.315),a positive correlation between serum C3 and Gensini score(r = 0.188),and a negative correlation between C1q,C1q/C3 ratio and Gensini score(r = 0.398,-0.490).Multivariate logistics analysis showed that only C1q/C3 ratio was proved to be an independent protective factor in patients with CHD(OR = 0.975 95%CI:0.957-0.953).During the one-year follow-up of each patient with CHD,23 patients had MACE,accounting for 20.54% of the patients who had not lost follow-up.The serum C1q level and C1q/C3 ratio in the MACE group were lower than those in the non-MACE group,but the difference was not statistically significant(P>0.05).KaplanMeier survival analysis showed that there was no significant difference in the risk of MACE between the low ratio group and the high ratio group(P>0.05),and further analyzed the MACE events one by one showed that the risk of non-fatal myocardial infarction was significantly increased in the low ratio group(P <0.05).Conclusion 1)The level of serum C1q and the ratio of C1q/C3 in patients with CHD were significantly lower than those in the control group,and decreased with the increase of the severity of coronary artery disease and the number of diseased branches;2)there was a positive correlation between serum C1q and C3,a negative correlation between serum C1q and C1q/C3 ratio and Gensini score,and a positive correlation between serum C3 and Gensini score;3)Multivariate logistics analysis showed that C1q/C3 ratio was an independent protective factor in patients with CHD;4)C1q/C3 ratio can predict the risk of non-fatal myocardial infarction in patients with CHD.