GDF-15Expression In The Serum Of Patients With Acute Coronary Syndrome And Its Clinical Signiifcance

Objective:The obiective of this study is to determine the levels of Growth differentiation factor-15(GDF-15) and high-sensitivity C-reactive protein(hs-CRP) in patients with coronary heartvdisease(CHD),compare their relationships,analyse the correlation between serum visfatin level and the degree of coronary arterial stenosis and plaque stability,and investigate the mechanism of visfatin in coronary heart disease.Methods:All sujects were enrolled from inpatients who underwent coronary angiography.we studied total of111patients.These included76patients with CHD,35controls.They were divided into three groups according to clinical hi story:normal control group,stable angina pectoris(SAP)group,acute coronary syndrome(ACS)group.they were divided into four groups according to the number of coronary artery stenosis:normal control group,single vessel disease group,double vessel disease group and multi vessel disease group.The severity degree of coronary artery stenosis was quantitively assessed according to coronary angiography by Gensini score.They were divided into four groups according to Censini score:normal control group,Gensini score<30group,30-60group and≥60group.The serum levels of GDF-15was measured by ELISA, hs-CRP was measured by immunoturbidimetry. Experimental data were processed by SPSS17.0statistical analysis software.A value of P<0.05was considered statistically significant.Results:(1) Basic treatment comparison study, found no difference between the CAD group and non-CHD patients was not statistically significant (P>0.05), no statistically significant difference between the group of patients with SAP and ACS group (P>0.05).(2) GDF-15levels in patients with coronary heart disease (CHD) group than non-CAD group (NC)(of872.29±243.89ng/1) vs (of389.89±123.98ng/1)(P <0.01)]. GDF-15levels of the acute coronary syndrome group (ACS) is higher than with stable angina pectoris (SAP)[(1079.19±212.41ng/1) vs (623.89±176.89ng/1),(P<0.01)]. With stable angina pectoris (SAP), GDF-15levels in patients with non-coronary heart disease group [(623.89±176.89ng/1) vs (389.89±123.98ng/1)(P>0.05)], acute coronary syndrome the patients were divided into three groups, the results show that GDF-15levels of the ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA)[(1134.78±173.78ng/1) vs (798.14±114.87ng/1) vs (690.12±110.21ng/1),(P<0.01)].(3) GDF-15levels increased with the increase in the number of diseased vessels and Gensini score level. Vessel coronary disease, double vessel disease, multivessel disease serum GDF-15levels were (530.81±210.12) and (680.59±286.52) and (996.79±216.23) ng/L; the Gensini integral<30group,30-60packets score>60serum GDF-15levels (321.1±111.1),(745.80±102.1)(1033.12±171.61) ng/L(4) Serum GDF-15levels and coronary heart disease in patients with high factors related to research, such as:age, blood sugar, blood lipids, blood pressure, weight, smoking, results showed that the level of serum in patients with high blood pressure, triglyceride levels, body mass indexand peripheral blood white blood cell count was positively related; was negatively correlated with the level of high-density lipoprotein; correlated with age, fasting blood glucose, no significant correlation between the level of low-density lipoprotein and total cholesterol levels.(5) Serum hs-CRP levels were statistically analyzed, the results showed that serum hs-CRP levels in ACS group, SAP group and non-CAD group were5.6(2.12-23.91),4.23(1.62-12.88),2.1(0.62-4.00) mg/d1.(6) hs-CRP levels had no significant correlation with the number of diseased vessels and Gensini score. Coronary artery single-vessel disease, double vessel disease, multivessel disease, respectively (10.99±12.57),(10.78±12.11),(10.14±11.82) mg/dl; the Gensini integral<30grouping,30-60grouping,>60The grouping were5.21(2.87-11.32),5.0(1.2-21.32),5.32(1.82-20.51) mg/d1. (7) Serum GDF-15level as an independent quantitative risk stratification of coronary heart disease and myocardial injury biomarkers hs_CRP multiple linear regression analysis, the results showed serum GDF-15levels were positively correlated with hs CRP.Conclusions:(1)The development of acute coronary syndrome in1.GDF-15has a certain relevance.(2)GDF-15may be detected as an indicator of the degree of coronary artery disease in patients with coronary heart disease.(3)GDF-15and hs-CRP was positively correlated, may be an inflammatory mediators, play a role in plaque instability.