The Correlation Between Free Fatty Acids And Stable Coronary Artery Disease And Acute Coronary Syndrome

Background: Coronary heart disease(CHD) is one of the main causes of deaths. CHD is of multi-factors. In addition to traditional risk factors such as smoking, hypertension, diabetes, and hyperlipidemia, a number of newly risk factors such as high uric acid hematic disease and homocysteine may also promote the progress of CHD. Dyslipidemia generally refers to the elevated LDL, reduced HDL and elevated triglycerides. Dyslipidemia is one of the most significant risk factor which was known to cause atherosclerosis. However, recent studies also found that FFA might be a possible risk factor of atherosclerosis. On one hand, free fatty acid is a material after decomposition of triglycerides and it is a necessary material of body activities, which can be used as an indicator of lipid metabolism level. On the other hand, many studies suggest that FFA is the independent biochemical indicators of oxidative stress and endothelial dysfunction. But the relationship between FFA and CHD is unclear. This study aims to explore the relationship between the level of FFA acids and CHD and acute coronary syndrome.Methods: A total 180 patients from 2013 to 2015, who underwent coronary angiography(CAG) in Union Hospital of Fujian Medical University because of tightness or chest pain, were included in this study.1. Based on the findings of CAG, medical history, electrocardiogram, the patients were divided into CHD group(n = 135), and the control group(n=45). 2. Based on the Gensini score of 30 as the cut-point, the patients were divided into the mild lesion group(n = 70) and the severe lesions group(n= 65). 3. According to the findings of CAG, medical history, electrocardiogram, myocardial enzymes and the troponin T, the patients were divided into three groups: stable coronary artery disease group(SCAD group, n= 60), acute coronary syndrome(ACS group, n= 75), the control group,(n=45). The clinical data and blood lipid profile between the different groups were compared; Pearson’s correlation and the binary logistic regression were used for analysis of relationship between free fatty acids and different types of coronary artery disease and the ROC curve was used to predict the sensitivity and specificity of acute coronary syndrome.Results:(1) Free fatty acid in the CHD group level was significantly higher than the Control group(0.59±0.34 VS 0.40±0.20,P<0.05), and Logistic regression analysis showed that free fatty acid was one of the risk factors for CHD.(2). Free fatty acid in the severe lesions group were significantly higher than those of the mild lesion group(0.71±0.38 VS 0.50±0.27, P<0.05). Pearson’s correlation analysis showed that the free fatty acid was correlated to the Gensini score, in addition, logistic regression analysis showed that free fatty acid increased the risk of CHD.(3)Free fatty acid in the SCAD group was significantly higher than the control group(0.56±0.22 VS 0.40±0.20,P<0.05), FFA in the ACS group was significantly higher than the control group(0.72±0.37 VS 0.40±0.20,P<0.05). Free fatty acid in the ACS group was significantly higher than that in the SCAD group(0.72±0.37 VS 0.56±0.22,P<0.05).(4) Using FFA for diagnosis of acute coronary syndrome, the area under the ROC is 0.78; when using 0.58 as a cutoff value, the diagnostic sensitivity was 0.61 with specificity of 0.81.Conclusion: FFA may be a risk factor of CHD, may correlate to the different types of CHD and the severity of coronary lesions; FFA may also be a potential predictor of ACS.