The Clinical Investigation On The Correlation Of VE-cadherin With In-stent Restenosis

[Background and Objectives]Coronary atherosclerotic heart disease refers to the coronary artery atherosclerosis and vascular cavity stenosis or occlusion caused by coronary artery functional change myocardial ischemia, hypoxia or necrosis caused by heart disease, a general designation of coronary artery sex heart disease(CHD), referred to as coronary heart disease (CHD), also known as ischemic heart disease. With the change of the diet and environment, the pace of life increased and the acceleration of population aging process, the incidence of coronary heart disease has increased year by year with onset younger trend in recent years,which has became the first killer of human health. Percutaneous coronary interention (PCI) has became the important means of treatment of coronary heart disease, including coronary artery in carotid stenting, which is currently the most widespread one kind of treatment, but there are certain deficiency, like the half a year stent restenosis (ISR) the incidence of around5%to10%, some myocardial infarction patients, with more target blood supply vessels revascularization, receive the worse outcome of the patients prognosis. At present one difficulty of coronary heart disease intervention treatment is how to effectively predict stent restenosis, which is hot topic at home and abroad. Vascular endothelial-cadherin,which is believed to be of major importance for the integrity of endothelial normal junctions and growth proventing endothelial barried with invasion from inflammatory cells and cytokines like goalkeeper,and could been seem to evaluate endothelial function.More and more clinical evidence indicate the necessity of VE-cadherin on the progress of endothelial repairing.our project are concerned abou the clinical correlation of serum VE-cadherin with in-stent restenosis for patients who receive PCI,also the relation between VE-cadherin with risk factor about in-stent restenosis,so that,through retrospective analyzing the severities of in-stent restenosis, clinical indexes and the serum levels of VE-cadherin, whether the serum VE-cadherin can be the biomarker of in-stent restenosis would be proved at this study.[Methods]During the period from201301to2013October,180patients from the Department of Cardiology in Baoan District people’s Hospital of Shenzhen city, take coronary angiography, and the clinical data were collected respectively from basic medical history, preoperative blood samples before coronary angiography, a month later, half a year after operation serum specimens, using enzyme-linked immunosorbent assay in patients with vascular endothelial cadherin (VE-cadherin) level and CRP the level of serum specimens were tested at the same time, including blood routine, liver and kidney function, blood lipid monitoring.55patients whose coronary angiography are normal as comparsional groups; the patients of coronary stenosis parallel stenting in125cases as the observation group, after the regular visits and in stent implantation after six months follow-up study of coronary angiography, completed a total of118patients,7patients were lost to follow-up, by using the QCA measurement method based on the review of target degree of stenosis of coronary angiography is divided into three grades, groups:normal coronary angiography quantitative measurement period of blood vessel diameter lost less than25%of cases of stent placement; Hyperplasia of endometrium mild group:coronary angiography quantitative measurement period of lost blood vessel diameter of stent placement was25%～50% of cases; Restenosis group:coronary angiography quantitative measurement period of blood vessel diameter lost more than50%of cases of stent placement.[Statistical processing]Measurement data with mean+/-standard error (SEM), according to comparison between multiple sets of using single factor analysis of variance (One-way ANOVA) method, the homogeneity of variance with Bonferonni or Turkey’s, analyze the multiple comparison between groups, the variance is not together with Dunnett’s T3method for multiple comparisons between groups. Count data to apply specific count and percentage, the results using X2test or Fisher test. Use SPSS17.0statistical software for statistical analysis, P<0.05was defined as statistically significant.[Results]1. This study included118cases of coronary heart disease in parallel PCI carotid stenting, PCI for at least six months after coronary angiography review, we found68cases of normal imaging,35cases of mild intimal hyperplasia,15cases of restenosis, stent restenosis rate is12.7%;2. Not narrow set of PCI postoperative stent, endometrium between mild hyperplasia and restenosis group refers to the age, sex, weight.Number and related cardiovascular risk factors (diabetes, high blood pressure, smoking, white blood cells, blood lipid (total cholesterol, triglycerides), CK-MB, LDH,etc. No statistical difference;3. There are no significant deference exist between deferent groups of serum VE-cadherin at time before PCI and one months after PCI,but compared with angiography normal group, stent restenosis and mild intimal hyperplasia group serum calcium concentration of mucin obviously higher (3.27+/-0.44vs.2.84+/-0.40vs.1.61+/-0.34, P=0.001); 4. Althogh high level of serum CRP were observed at time before PCI and one months,half one years after PCI except no significant deference exist between deferent groups, the diference concentration of serum VE-cadherin gain statistics at time of half one years but no at time before PCI and one months after PCI;5. There are significant difference gained between the level of serum VE-cadherin and length of nidus coronary artery by Bivariate analysis,which the value of Spearman correlation index(r=0.661, P=0.031),mediated between0.8and0.5,reveals the Moderate relation for the two factor;6. No correlation between serum calcium concentration of mucin and age (r=0.07, P=0.07), or men and women (1.94+0.93vs.1.84+/-0.54, P=0.876).7. The means of Receiver operating characteristic to explore the diagnostc value of moderate and severe In-stent restenosis,incated area under the curve of VE-cadherin for the severe In-stent restenosis was0.853, P=0.001, and the following with the specificity(0.933),sensibility(0.804) and the value of cut-off is2.55ng/ml; area under the curve of VE-cadherin for severe In-stent restenosis was0.915,P=0.001,following with specificity(0.954),sensibility(0.865) and the value of cut-off is2.05ng/ml.[Conclusion].(1). Vascular endothelial cadherin (VE-cadherin) is of great significance to judge stent restenosis, perhaps be used as a judgement of stent restenosis ideal biomarker;(2). The longer the lesions in patients with nidus coronary artery, the higher the calcium concentration of mucin.