The Study Of The Relationship Between Serum MAL Protein Level And Acute Coronary Syndrome

Objective:To study the clinical value of detecting serum MAL protein level for acute coronary syndrome and the lesion severity of coronary arteries.Method:1.Select 122 patients of the 1st affiliated hospital of BBMC,department of cardiology,between January 2020 and October,after a whole consideration of clinical symptoms,electrocardiogram,blood test like myocardial enzyme profiles,cardiac troponins,primarily diagnosed as acute coronary syndrome as research subjects that underwent coronary angiography in cardiac catheter room during inpatient.According to the results of coronary angiography,clinical syndromes and laboratory test results,divide acute coronary syndrome group into subgroups: Unstable angina group,including 62 members and Acute myocardial infraction group,including 60 members.Select 60 subjects that underwent coronary angiography during the same time in our hospital,department of cardiology but without markable coronary artery straitness and describe these subjects as control group.2.With all subjects agreement,select their normal information like name,gender,age,post chronic diseases histories like hypertension,diabetes,hereditary diseases,neoplastic diseases and the treatment of these disease,their normal blood pressure level,blood glucose level.In the second day morning of inpatient,collect 2 parts blood sample of the patients,from venae mediana cubiti.Using one blood sample for biochemical test,another blood sample to test serum MAL protein level using ELISA kit.Coronary artery lesions were recorded when the subjects completed coronary angiography.3.Using IBM spss26.0 to analyze data collected by the test.Independent sample t test for measurement data and chi square test for enumeration data between two groups.ANOVA for the compare between three groups.Pearson was used for correlation between data analysis.Draw ROC curve（receiver operation characteristic curve）to analysis the prognostic value of serum MAL protein for acute coronary syndrome.when P number <0.05,as the criteria of “statistically different”Results:1.In the experiment,serum MAL protein level in acute coronary syndrome patients is 36.68±11.27 pg/ml,in control group,serum MAL protein level is 25.85±5.51pg/ml,acute coronary syndrome group is remarkable higher than negative control group.P<0.05 the difference has statistic meaning.Divide acute coronary syndrome group into subgroups: UA group and AMI group,serum MAL protein of two groups were38.10±10.03 pg/ml,35.30±12.28pg/ml respectively.Using one way ANOVA to compare the serum MAL protein levels between these two groups and control group,serum MAL protein levels among three groups are not equal,further post hoc analysis indicate that serum MAL protein between acute myocardial infraction group and unstable angina group has no statistic difference（P >0.05）.serum MAL protein in unstable angina group and acute myocardial infraction group are statistically higher than control group（P >0.05）.2.According to the coronary angiography findings of acute coronary syndrome patients,based on the number of lesioned coronary arteries,divide acute coronary syndrome patients into subgroups: one artery lesioned,two arteries lesioned or three arteries lesioned.In order to study whether there are some relationship between the number of lesioned coronary arteries and serum MAL protein level in acute coronary syndrome patients.Statistic analysis showed that the number of lesioned coronary arteries has no direct relationship with serum MAL protein level（P >0.05）.3.With the help of gensini score system,we evaluate the severity of coronary arteries by score in patients with acute coronary syndrome.Tried to know whether there are some relationship between serum MAL protein level and the severity of lesioned coronary arteries in acute coronary syndrome patients,the results showed that serum MAL protein level has no relationship with the severity of lesioned coronary arteries in acute coronary syndrome patients（P >0.05）.4.Using ROC curve to evaluate that prognostic value of serum MAL protein level for acute coronary syndrome,the area under curve（AUC）of serum MAL protein for predicting acute coronary syndrome is 0.814.Our selected patients with acute coronary syndrome were divided into acute coronary syndrome into unstable angina and acute myocardial infraction,we discover that the AUC of serum MAL protein level for predicting unstable angina and acute myocardial infraction is 0.768 and0.863 respectively.Using maximum cut point of the Joden index of the ROC curve as critical point,serum MAL protein level predicting acute coronary syndrome is sensitivity 0.623,specificity 0.917.Acute coronary syndrome was further classified into unstable angina and acute myocardial infarction,serum MAL protein level predicting unstable angina is sensitivity 0.597,specificity 0.867,predicting acute myocardial infraction is sensitivity 0.733,specificity 0.917.Statistics indicated that serum MAL protein level has some diagnostic value for acute coronary syndrome,unstable angina and acute myocardial infraction.Conclusion:Serum MAL protein level of acute coronary syndrome group are notably higher than control group,Serum MAL protein level may has some relationships with the clinical onset of acute coronary syndrome,but may has no relationship with the severity of coronary arteries in patients with acute coronary syndrome.It has no relationship with the number of lesioned coronary arteries in acute coronary syndorme patients.The protein has some predictive value for acute coronary syndrome,unstable angina,acute myocardial infraction.The serum level of the protein may be helpful to diagnose acute coronary syndrome.