Study On The Correlation Between The Severity And Prognosis Of CRP And NSTEMI In Patients With Hypersensitivity

Objective:With the improvement of people’s living standard,acute coronary syndrome has become the focus of people’s attention.Acute coronary syndrome includes acute ST segment elevation myocardial infarction,acute non ST segment elevation myocardial infarction and unstable angina pectoris.High sensitivity CRP is a rapid and simple biochemical test.The relationship between high sensitivity CRP and acute ST segment elevation myocardial infarction and unstable angina pectoris was studied,the patients with acute non ST segment elevation myocardial infarction are mainly middle-aged and old,the condition is complex,and there are many influencing factors,there are few reports about the relationship between CRP and acute non ST elevation myocardial infarction.The clinical evaluation of acute non ST elevation myocardial infarction severity and prognosis methods with GRACE score and TIM1 score,but the steps of these evaluation methods is complicated,involving the risk factors of coronary heart disease are more time-consuming,and high sensitivity CRP as a simple and rapid biochemical index,has great advantages.This article focuses on the relationship between the level of CRP and the severity of coronary artery lesions in patients with acute non ST elevation myocardial infarction,as well as to investigate whether CRP can predict the prognosis of patients with acute non ST myocardial infarction.Methods:From the the First Affiliated Hospital of Dalian Medical University two cases inspection system and the NSTEMI database for selected patients with acute non ST segment in 2014 01 to December 31,2015 01 patients hospitalized with elevation myocardial infarction in 522 cases,of which a total of 287 patients underwent coronary angiography,blood tests and high sensitivity CRP and coronary angiography in 164 cases,the 164 patients were enrolled as the research object.The clinical data of all patients were recorded,such as sex,age,past history(hypertension,diabetes,cerebrovascular disease,etc.),hypersensitivity CRP,blood lipid,left ventricular ejection fraction,and so on.The patients were then followed up to see if MACCE events and survival were recorded.MACCE mainly includes all cause death,recurrent myocardial infarction,recurrent angina pectoris,unstable angina pectoris and heart failure.Follow up deadline is December 31,2016.Results:According to the general situation of all the patients were divided into two groups according to the level of hs-CRP,high s-CRP group(more than 3.0mg/L)and low hs-CRP group(less than 3.01mg/L).The high s-CRP group of 79 cases,85 cases in low hs-CRP group.According to the results of coronary angiography,in order to facilitate the quantitative analysis and comparison of the severity of coronary lesions,the introduction of a new Gensini score,the overall degree of coronary stenosis into a specific intuitive value.The new Gensini score:8 major segments of the coronary artery stenosis score,no abnormality was found for the score of 1%-49%in the range of(75%-99%)was 13 50%-74%was 3,and the occlusion was 4.The results showed that there was a significant high hs-CRP group and low hs-CRP group Gensini score(p<0.05).In addition,according to the follow-up of patients with or without MACCE events,divided into MACCE group and no MACCE group,MACCE group of 31 patients,no MACCE group of 129 cases,loss of follow-up in 4 cases.The CRP level of patients with no MACCE event group was 4.08±3.69mg/L,which was significantly lower than that of the patients in the MACCE group,and was higher than that of the patients in the group6.66±1.91mg/L.Univariate and multivariate COX regression analysis showed that CRP was an independent predictor of future MACCE events in patients with acute non ST segment elevation myocardial infarction(RR=1.126,95%CI(1.052,1.205),P=0.001).The Kaplan-Meier survival curve indicates that with high sensitivity CRP level increasing,event free survival rate was significantly lower in patients with acute non ST elevation myocardial infarction(log rank x 2=9.339,P=0.002).Conclusion:1.the level of CRP was positively correlated with the severity of coronary artery lesions in patients with NSTEMI;2.high sensitivity CRP predicts adverse outcomes in patients with NSTEMI.