The Relationship Between Thrombin Activatable Fibrinolysis Inhibitor And Coronary Heart Disease: A Case-control Study

Objective: This study is based on the investigation of medical record information carried out in the Central Hospital of Fushun,using a case-control study to explore the relationship between serum thrombin-activatable fibrinolysis inhibitor(TAFI)level and coronary heart disease and different types of coronary heart disease in order to explore new diagnostic marker for coronary heart disease and provide a basis for preventive measures.Methods: A total of 444 subjects were included in this study.From April 2018 to September 2019,a total of 222 patients diagnosed with coronary heart disease in the Central Hospital of Fushun were selected as the case group.According to the clinical type of coronary heart disease,they can be divided into stable angina pectoris subgroup100 cases and unstable angina pectoris subgroup 44 cases and 78 cases of acute myocardial infarction subgroup,and 222 patients with non-coronary heart disease during the same period were selected as the control group.The concentration of TAFI in serum was measured by immune turbidimetry.The logistic regression was used to construct models of influencing factors of coronary heart disease and its subgroups.Restricted cubic spline function combined with logistic regression was used to explore the dose-response relationship between serum TAFI level and coronary heart disease and its subgroups.Results: 1.The serum TAFI level of the coronary heart disease group was higher than that of the control group,and the difference was statistically significant(P=0.002).The serum TAFI level in the acute myocardial infarction subgroup was higher than that in the control group,and the difference was statistically significant(P=0.016),while the serum TAFI level in the stable angina pectoris subgroup and unstable angina pectoris subgroup were higher than that of the control group,but the difference were not statistically significant(P=0.780;P=0.097).2.Through muiltivariate logistic regression models,it was found that the risk of CHD in the high-level TAFI(>22.89 μg/m L)was 1.64 times of the low-level TAFI(≤22.89 μg/m L),the difference was statistically significant(P=0.046),the risk of UAP in the high-level TAFI(>22.89 μg/m L)was 2.67 times of the low-level TAFI(≤22.89μg/m L),the difference was statistically significant(P=0.008),the risk of AMI in the high-level TAFI(>22.89 μg/m L)was 2.63 times of the low-level TAFI(≤22.89 μg/m L),the difference was statistically significant(P=0.048).3.According to the dose-response relationship,the risk of coronary heart disease decreased and then increased as the serum TAFI level increases,and this correlation was statistically significant(P=0.0074).4.In the coronary heart disease subgroups,according to the dose-response relationship,the risk of unstable angina pectoris decreased and then increased as the serum TAFI level increases,and this correlation was statistically significant(P=0.0087).the risk of acute myocardial infarction increased and then decreased and increased finally as the serum TAFI level increases,and this correlation was statistically significant(P=0.0243).Conclusions: The serum TAFI level of patients with coronary heart disease was significantly higher than that of the control group.In the coronary heart disease subgroups,the serum TAFI level of patients with acute myocardial infarction was significantly higher than that of the control group,while the serum TAFI levels in the stable angina pectoris subgroup and unstable angina pectoris subgroup were no difference with the control group.High level of TAFI was a risk factor for coronary heart disease.In the coronary heart disease subgroups,high levels of TAFI were risk factors for unstable angina pectoris and acute myocardial infarction.The risk of coronary heart disease decreased first and then increased with the increase of serum TAFI level.In the coronary heart disease subgroups,the risk of unstable angina pectoris decreased first and then increased with the increase of serum TAFI level.The risk of acute myocardial infarction increased and then decreased and increased finally with the increase of the serum TAFI level.