The Value Of Plasma Lipoprotein Associated Phospholipase A2 And Heart Type Fatty Acid Binding Protein In Risk Stratification And Pathological Changes Of Elderly Patients With Acute Coronary Syndrome

Objective: The purpose of this study was to explore the relationship between the expression of Lp-PLA2 and H-FABP in elderly patients with acute coronary syndrome(ACS)and the degree of coronary lesions and risk stratification,and to further analyze whether they have predictive value for major adverse cardiovascular events(MACE)in the near future.Methods:From October 2017 to June 2019,97 patients(age ? 60 years old)with ACS were selected from the emergency department and the geriatric ward of the Affiliated Hospital of Inner Mongolia Medical University for chest distress and chest pain,and 32 patients(age ? 60 years old)without obvious abnormality were selected as the normal control group.All patients with ACS underwent coronary angiography,and the degree of coronary lesions was quantified by Gensini integral system.The results were divided into mild,moderate and severe lesions group by three-dimensional interval;high risk group,medium risk group and low risk group according to grace scoring system.The concentrations of Lp-PLA2 and H-FABP were measured by enzyme-linked immunosorbent assay.To analyze the correlation between the levels of Lp-PLA2 and H-FABP and the degree of coronary lesions and risk stratification.To record whether there was mace in ACS patients within 3 months after discharge,and to screen the factors influencing mace events.Result:(1)The levels of H-FABP and Lp-PLA2 in elderly patients with ACS were higher than those in the control group(P < 0.05).(2)The elderly ACS patients were divided into three groups according to grace scoring system.The level of plasma H-FABP in low-risk group,medium risk group and high-risk group increased in turn,with statistical significance(P < 0.05);the level of plasma Lp-PLA2 in high-risk group was higher than that in low-risk group and medium risk group,with statistical significance(P < 0.05).The level of Lp-PLA2 in low-risk group and high-risk group was higher than that in low-risk group There was no significant difference between the two groups(P > 0.05).(3)According to the results of coronary angiography,the elderly ACS patients were divided into mild,moderate and severe disease groups according to the Gensini integral.The levels of H-FABP and Lp-PLA2 in the severe disease group were higher than those in the moderate and mild disease group(P <0.05),There was no significant difference between moderate pathological group and mild pathological group(P > 0.05).(4)ROC curve analysis showed that the area under the curve predicted by the levels of H-FABP and Lp-PLA2 at admission was 0.756 and 0.735 in the high-risk group of grace score,respectively;the area under the curve predicted by the levels of Lp-PLA2 and H-FABP at admission was 0.796 in the high-risk group of grace score.(5)ROC curve analysis showed that the area under the curve predicted by the levels of H-FABP and Lp-PLA2 was 0.811 and 0.746 respectively,and the area under the curve predicted by the levels of Lp-PLA2 and H-FABP was 0.828.(6)The results of univariate analysis indicated that the concentrations of Lp-PLA2 and H-FABP were higher in elderly ACS patients with mace within 3 months after admission(P < 0.05).Conclusions: The levels of H-FABP and Lp-PLA2 in the elderly patients with ACS are positively correlated with the risk stratification of grace score;the levels of H-FABP and Lp-PLA2 in the elderly patients with ACS can predict the elderly patients with high risk of ACS,and the combined prediction effect is better;the levels of H-FABP and Lp-PLA2 in the elderly patients with ACS are positively correlated with the degree of coronary lesions;the levels of H-FABP and Lp-PLA2 in the elderly patients with ACS can predict the severe coronary disease,and the combined prediction effect is better;The level of H-FABP and Lp-PLA2 may be the risk factors of mace in elderly ACS patients within 3 months.