The Predictive Value Of Plasma Osteoprotegerin In The Risk Stratification Of Premature Acute Coronary Syndrome

Objective:The aim of this study was to compare plasma Osteoprotegerin(OPG)levels in patients with premature acute coronary syndrome(PCHD)who were divided into low,moderate and high-risk groups according to their GRACE scores,to explore the relationship between Plasma Osteoprotegerin and different risk stratification of premature acute coronary syndrome and its predictive value for high-risk group,the incidence of recurrent acute cardiovascular events(MACE)in 6 months between groups with different baseline levels of Plasma Osteoprotegerin(OPG)was observed to explore the relationship between OPG at different baseline levels and the incidence of events.Methods:A total of 210 patients(106 males,48.86 ± 4.65 years old,104 females)were admitted to the Department of Cardiology in 2021,Dong guan Branch Hospital of Yan ’an university,August 2019,age 54.65 ± 6.49 years.Data Collection: General Information was recorded on admission and medical records were written,patients were asked to take blood samples from the next day for 8 hours,and related biochemical index samples were collected on the next day and sent to the laboratory of our hospital,the plasma osteoprotegerin concentration was determined by Elisa after the EP tube was frozen at 80 °C.All patients were divided into PCHD group(150 cases)and Control Group(60 cases)according to the results of coronary angiography(Cag)and coronary angiography(CAG)Then,41 patients in PSAP group and 109 patients in PACS group were divided into two groups according to clinical manifestation,ECG changes and myocardial injury markers PACS group was divided into low-risk Group,medium-risk Group and high-risk Group(Grace Score≤108,108-140,> 140).According to GRACE score group,the level of OPG was analyzed and compared among the groups.Pearson Correlation Analysis was used to analyze the correlation between OPG and Grace Score,after that,binary Logistic regression analysis was used to analyze the risk factors of high-risk group with Grace Score,and ROC curve was used to analyze the predictive value of plasma OPG level in high-risk group,the incidence of Mace events within half a year was compared between the two groups.Results:1.The family history,LDL-C and HCY of CHD group were significantly higher than those of Con Group in PCHD group(p < 0.05)Age,uric acid,cystatin C,triglyceride,ischemia-modified Albumin,apolipoprotein a 1,Apolipoprotein B,total cholesterol and ddimer PCHD group were higher than CON group(p > 0.05).2.The level of plasma OPG in PCHD group was significantly higher than that in CON group(p < 0.001),and that in PACS group was higher than that in PSA group (p < 0.001).3.The HCY and LDL-C in PACS group were higher than those in PSAP group(p < 0.05).4.The PACS group was divided into low,middle and high risk groups according to GRACE score,and the levels of smoking history,LDL-C and OPG in high risk group were significantly higher than those in middle and low risk group(p < 0.05).The level of plasma OPG was positively correlated with the GRACE score in PACS Group(R= 0.591,p <0.001).5.Binary Logistic regression showed that plasma OPG and hypertension history were independent risk factors in PACS group(or = 1.011,95% CI = 1.005-1.016,p < 0.001;or = 3.451,95% CI = 1.101-10.820,p = 0.034).6.The ROC curve was used to analyze the predictive value of OPG for the High Risk Group of Grace Score in PACS.The area under the ROC curve(AUC)= 0.823,95% CI = 0.724-0.905,p < 0.001.When opg = 396.64,the Yoden index was 0.518,and the sensitivity and specificity were 80.4% and 71.4%,respectively.Kill.7.PACS group was divided into high OPG group(55 cases)and low OPG group (54 cases).The incidence of intra-hospital and intra-hospital Mace events was compared between the two groups(p > 0.05),and the incidence of intra-hospital and intra-hospital Mace events was significantly different between the two groups(p < 0.05).Conclusion:1.The level of plasma OPG was positively correlated with the GRACE score in PACS Group(R= 0.591,p < 0.001).2.Plasma OPG ≥396.64 pg/ml suggests a higher risk of ischemia in PACS.3.High Plasma OPG levels suggest a high incidence of long-term Mace events.