The Importance Of Serum Neopterin Concentrations In Patients With Coronary Heart Disease

Objective To explore the importance of neopterin on risk stratification inpatients with coronary heart disease.Method66in-hospital patients underwent diagnostic coronary angiographyin our cardiovascular department had been studied. The patients consisted ofthree groups:20patients with negative coronary angiograms in control group,21patients with stable angina pectoris in SAP group and25patients with acutemyocardial infarction or unstable angina pectoris in ACS group. All patients’general clinical data had been recorded, such as gender, age, blood pressure,ankle-brachial index, body mass index, blood lipid, prevalence of type2diabetes and smoking rates(smoking index＞200). The severity of coronaryartery disease on the basis of CAG was identified by Gensini score. Serumneopterin concentration was measured by enzyme-linked immuno sorbentassay (ELISA), and explored the relationship between Npt and other clinicaldata. All patients were divided into four groups according to quartiles of Npt.The relationship between Npt and the onset of CHD/ACS had been discussed.Result1、The concentration of serum neopterin and hs-CRP, and Gensiniscore were all significantly higher in ACS group than those in SAP group andcontrol group(P＜0.05). Compared with control group, there were higherserum neopterin levels, hs-CRP concentration and Gensini score in patients inSAP group (P＜0.05).2、The concentration of serum Npt was positivelycorrelated with hs-CRP(rp=0.602, P＜0.001; partial correlation coefficient0.338, P=0.012) and with Gensini score (rp=0.757, P＜0.001; partialcorrelation coefficient0.353, P=0.009). The concentration of serum Npt hadsignificantly positive correlation with onset of CHD and ACS (partial correlation coefficient0.673and0.551, P＜0.001).3、All patients were divided into fourgroups according to quartiles of Npt. The result of the risk analysis showedthat: the risk of ACS in the third quartile group was higher than the secondquartile group (OR=15.000，95%CI:2.552,88.170, P=0.001). The risk of ACSin the fourth quartile group was20.625times of the second quartile group(OR=20.625，95%CI:3.188，133.446, P=0.000).Conclusions The neopterin levels has positive correlation with the severityof coronary artery lesions, and it has positive correlation with the onset of CHDand ACS. The result of our study suggests that neopterin concentration mayplay an important role in risk stratification of CHD.