Relationship Between Blood C-reactive Protein,Cystatin C, Apolipoprotein A, And Lipoprotein A And Grace Risk Score In Patients With Non-st Segment Elevation Acute Coronary Syndrome

Objective:To evaluate the relationship between serum high-sensitivity C-reactive protein (hs-CRP), cystatin (CysC), apolipoprotein A (ApoA), lipoprotein a (Lp(a)) and the global registry of acute coronary events (GRACE) risk scores in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS).Methods:From January2012to May2013, a total of155consecutive hospitalized patients with established final diagnoses of non-ST-segment elevation ACS were prospectively enrolled in this observational study. The diagnosis of NSTE-ACS was established on the basis of current guidelines. All the patients were divided into non ST segment elevation myocardial infarction (NSTEAMI) group and unstable angina pectoris (UA) group. Also,87patients without coronary heart disease severed as control group. After admission, baseline clinical characteristics were prospectively recorded, GRACE risk score in the NSTE-ACS group were calculated and serum levels of hs-CRP, CysC, ApoA and Lp(a) were measured, all blood samples were obtained before coronary angiography within24hours of hospital admission which were collected from each patients antecubital vein. All patients received standard ACS therapy including aspirivein(aortocoronary artery)bypass graftconverting enzyme(ACE) inhibitors, beta-blockers, and statins as recommended by the guidelines. Patients were submitted to coronary angiography someday. The patients were divided into low(1-99), intermediate(100-140) and high risk(141-372) groups according to the GRACE risk scores. Results:1、The levels of serum hs-CRP, CysC, Lp(a) and the GRACE risk scores in NSTE-ACS patients were significantly increased compared with the control group, while the level of serum ApoA was significantly decreased(P<0.05).2、With the increase of GRACE risk scores, the levels of serum hs-CRP, CysC, Lp(a) were significantly increased, while the level of serum ApoA was decreased significantly(P<0.05).3、The correlation analysis showed that GRACE risk scores had positive correlation with hs-CRP, CysC, Lp(a)(r=0.424, P<0.01;r=0.549, P<0.01; r=0.134, P<0.01), and a negative correlation with ApoA (r=-0.167, P<0.01). Furthermore, the multiple linear regression analysis showed that the CysC and hs-CRP had the greatest influence on the GRACE risk scores.Conclusion:1、The levels of hs-CRP, CysC, ApoA, Lp(a) are closely related to coronary heart disease, which might be used as better indicators of extent of coronary atherosclerosis.2、For the NSTE-ACS patients, the higher of the levels of hs-CRP, CysC, ApoA, Lp(a), the higher of the GRACE risk scores. Combination of these biomarkers may have the important clinical value on early risk stratification, evaluation of prognosis and treatment options.