Correlation Between APAR、NPAR And The Severity Of Coronary Artery Lesions In Patients With Acute Coronary Syndrome

Objective:By studying the correlation between the ratio of alkaline phosphatase to albumin(APAR),the percentage of neutrophils to albumin(NPAR)and the severity of coronary artery disease in patients with acute coronary syndrome(ACS),the clinical significance of APAR and NPAR in evaluating the severity of coronary artery disease in patients with ACS was discussed.Materials and Methods:A total of 227 patients diagnosed with ACS who were admitted to the Department of Cardiovascular Medicine,Dongguan Branch of the Affiliated Hospital of Yan ’an University from October 2019 to December 2020 were collected.ACS patients were divided into unstable angina pectoris(UA)group and acute myocardial infarction(AMI)group according to coronary angiography(CAG)results,laboratory biomarkers and electrocardiogram findings.Gensini score was performed on all patients with ACS according to the results of CAG examination,and they were divided into low-risk group(Gensini score≤30 points)and medium-risk group(30 points<Gensini score≤60)and high-risk group(Gensini score>60 points).In addition,60 cases of non-CHD patients with suspected CHD who underwent coronary angiography(CAG)during hospitalization without obvious coronary artery stenosis were selected as the control group.General data(age,sex,BMI,blood pressure,smoking history,history of hypertension,and history of diabetes mellitus)were collected and recorded.WBC,NEU,ALB,ALP,LYM,TC,TG,LDL-C,HDL-C laboratory indexes were collected and recorded,and NPAR and APAR were calculated.Gensini scores of ACS patients were recorded.The general and clinical data of AMI group,UA group and control group were compared.The general data and clinical data of low-risk group,medium-risk group and high-risk group were compared.Spearman correlation analysis was used to evaluate the correlation between APAR,NPAR and Gensini scores in ACS patients.Ordered Logistic regression model was used to screen the risk factors affecting the severity of coronary artery disease in ACS patients.The predictive value of APAR and NPAR for high Gensini score in ACS patients was evaluated by drawing ROC curve.Results:1.There were no significant differences in gender,age,smoking history,hypertension,diabetes,BMI,SBP and DBP between AMI group,UA group and control group(P>0.05).2.There was no significant difference in TG,LDL-C between AMI group,UA group and control group(P>0.05).The WBC,NEU and ALP in AMI group were significantly higher than those in UA group and control group,and the difference was statistically significant(P<0.05);The levels of LYM,ALB and HDL-C in AMI group were significantly lower than those in UA group and control group,and the difference was statistically significant(P<0.05);ALP and WBC in AMI and UA groups were higher than those in control group,and the difference was statistically significant(P<0.05);The levels of ALB and HDL-C in AMI and UA groups were lower than those in control group,and the difference was statistically significant(P<0.05);The TC in AMI group was higher than that in UA group,and the difference was statistically significant(P<0.05);The level of TC in UA group was higher than that in control group,and the difference was statistically significant(P<0.05).3.APAR and NPAR in AMI group were significantly higher than those in UA group and control group,and the differences were statistically significant(P<0.05);The NPAR of the UA group was higher than that of the control group,and the difference was statistically significant(P<0.05);Gensini score in AMI group was higher than that in UA group,and the difference was statistically significant(P<0.05).4.There were no statistically significant differences in gender,smoking,hypertension,diabetes,age,BMI,systolic blood pressure and diastolic blood pressure among the low-risk group,medium-risk group and high-risk group(P>0.05).5.There were no statistically significant differences in WBC,TC,TG,LDL-C and HDL-C among the low-risk group,medium-risk group and high-risk group(P>0.05).The differences in NEU,LYM,ALB and ALP were statistically significant(P<0.05).Pairwise comparison among the three groups showed that the WBC of the high-risk group was higher than that of the control group,and the difference was statistically significant(P<0.05);LYM and ALB in the high-risk group were higher than those in the control group,and the difference was statistically significant(P<0.05);ALP level in high-risk group was higher than that in medium-risk group,and the difference was statistically significant(P<0.05);ALB levels in the medium-risk group were lower than those in the control group,and the difference was statistically significant(P<0.05).6.There were statistically significant differences in APAR and NPAR in the low risk group,medium risk group and high risk group(P<0.05);The APAR and NPAR of the high-risk group were higher than those of the low-risk group and the medium-risk group,and the differences were statistically significant(P<0.05);The NPAR of the medium-risk group was higher than that of the low-risk group,and the difference was statistically significant(P<0.05).7.Spearman correlation analysis showed that ALB level was negatively correlated with Gensini score in ACS patients;NEU,ALP,APAR and NPAR were positively correlated with Gensini scores.8.Orderly Logistic regression analysis model showed that ALB,NEU,ALP,APAR and NPAR were risk factors affecting the severity of coronary artery disease in patients with ACS(P<0.05).9.The results of ROC curve showed that the optimal APAR cut-off value was 2.42,the sensitivity was 45.0%,and the specificity was 79.4%.The best cutoff value of NPAR was 1.96,the sensitivity was 53.0%,and the specificity was 81.1%.Comparing the area under the curve,APAR and NPAR show better predictive value than ALB,ALP and NEU alone.Conclusion:1.APAR and NPAR were positively correlated with the severity of coronary artery disease in patients with ACS.The higher the levels of APAR and NPAR,the more severe the coronary artery disease in patients with ACS;2.APAR and NPAR can be used as predictors of severity of coronary artery disease in patients with ACS;Compared with NEU,ALP,and ALB alone,APAR and NPAR can better predict the severity of coronary artery disease in patients with ACS.