Relationship Between Toll Like Receptors 4 And Coronary Lesions In Patients With Coronary Heart Disease

Objective:To investigate the relationship between the level of TLR4 and the Gensini score of coronary artery stenosis by analyzing the correlation between Toll like receptors 4(TLR4)and coronary artery stenosis in patients with coronary heart disease(CHD).Methods:A total of 339 patients suspected CHD admitted to hospital with chest pain were selected in the study.All patients were underwent coronary angiography.Among them,34 cases of coronary angiography were normal(no stenosis and plaque were found in the coronary artery)as control group.There were 141 cases with at least one vessel diameter stenosis ≥50 % as CHD group.Coronary plaque formation but vessel diameter narrow<50% of the population of 164 patients were not grouped.Gensini score was used to measure the severity of coronary artery disease.According to the results of coronary angiography,45 cases were divided into single vessel lesions group,72 cases of double vessel lesions group and 24 cases of three vessel lesions group,and then according to the Gensini score,all of the patients were divided into low score group(8 ~ 20 points)37 cases,the middle score group(21 ~ 40 points)65 cases and high score group(> 40 points)39cases.Collected all selected subjects clinical data and biochemical indicators.The differences of TLR4 levels between each groups were compared.The factors influencing the coronary artery lesion were analyzed by univariate analysis and multivariate logistic regression.The confounding factors were excluded The relationship between TLR4 level and severity of coronary artery lesion was determined by linear correlation analysis.Results:(1)Compared with the control group,the level of TLR4 in CHD group was significantly increased [(60.10±11.44)ng/ml vs(102.77±29.58 ng/ml,P <0.05];(2)The level of TLR4 in three vessel lesions group was significantly higher than that in double vessel lesions group and single one [(143.09±19.39)ng/ml,(104.66±22.49)ng/ml vs(78.24±16.24)ng/ml,P <0.05];(3)The level of TLR4 was significantly higher in the high score group compared with the low and middle score group [(131.79±23.12)ng/ml vs(86.82±18.57)ng/ml,P <0.05];(4)Univariate analysis and multivariate logistic regression analysis showed that there were three factors of Gensini score in CHD group: TLR4,hs-CRP and diabetes mellitus.TLR4 was one of the influencing factors of Gensini score(OR=15.645,95%CI : 5.322-45.994;P < 0.001),diabetes mellitus(OR=8.585,95%CI :2.986-24.687;P<0.001),hs-CRP(OR=4.942,95%CI:1.540-15.863;P=0.007);(5)TLR4 levels were positively correlated with Gensini scores(r = 0.539,P = 0.001),and TLR4 levels varied with Gensini score.Conclusions:(1)The level of TLR4 in CHD patients was significantly higher than that in normal controls,indicating that TLR4 was involved in the pathogenesis of CHD.(2)The higher the number of coronary artery lesions in CHD patients,the higher the level of TLR4;the higher the Gensini score of coronary artery lesions,the higher the level of TLR4;(3)There were three factors of Gensini score in CHD group: TLR4,hs-CRP and diabetes mellitus.(4)TLR4 was positively correlated with Gensini score,and the TLR4 level increased with the increase of Gensini score.(5)TLR4 levels can initially reflect the severity of coronary artery lesions in patients with CHD.Understanding the relationship between TLR4 and Gensini score can help clinicians find patients with coronary artery disease.