The Change Of Serum CTRP5 In Patients With Unstable Angina Pectoris In 24h After Percutaneous Coronary Intervention

Objective: The coronary atherosclerotic heart disease(CAD)is caused by abnormal metabolism of lipid,which leads to the lipid in blood adhering to the smooth arterial intima.There are some white plaques resulted from accumulation of lipid materials.The morbidity of CAD increases with the improvement of the life standard.It was reported that CAD had become the first cause of death according to the statistics of WHO.It is considered that the coronary heart disease is caused by the formation of unstable inflammatory plaque on the basis of atherosclerosis on the conditions of many risk factors.Tumor necrosis factor-related protein 5(CTRP5)is a member of complement C1q/tumor necrosis factor-related proteins.It widely express in many tissues.It participates in many physiological processes including immune defence,inflammation and cell differentiation.It could aggravate the injury of blood vessel,depress the function of endothelial cells and vasodilatation.It has the ability of promoting atherosclerosis.The existence of CTRP5 is correlated with the degree of severity of coronary artery disease.It is the bridge to connect the vascular inflammation with atherosclerosis.With the development of diagnosis and treatment,the appearance of interventional therapy covers the shortage of conservative treatment with drugs.It is the advantages including small trauma,high safety,short time-consuming,fast recovery and obvious effect on the symptoms that makes interventional therapy develop and popularize quickly.But the complication of stent implantation in patients with coronary heart disease has became the outstanding matter of curative effect of interventional therapy.However,some studies indicated that the increase of inflammatory factors,such as hs-CRP?IL-6,after the stent implantation would result in the appearance of complications such as in-stent restenosis.The clinical studies showed that it would benefit from recognition of inflammatoryreaction of stent implantation to carry out risk classification for patients and early intervention therapy.The aim of the study is to investigate change of CTRP5 and hs-CRP in serum in 24 h after percutaneous coronary stent implantation to provide theoretical basis for the early inflammation of stent implantation and early anti-inflammatory therapy to improve the prognosis of intervention therapy.Methods:1 The patients who would take coronary arteriography or stent implantation were selected from January to December in 2016 in the Department of Cardiology in Gucheng Hospital in Hebei province according to the guidelines of the diagnosis and treatment from American College of Cardiology/ American Heart Association(ACC/AHA)in 2014.The patients were distributed into 3 groups including 80 patients with unstable angina pectoris,60 patients with stable angina pectoris and 50 patients with no angina pectoris who took only coronary arteriography as control.2 The basic clinical data of patients were collected,such as age,gender,hypertension or not,diabetes or not and so on.3 The elbow venous blood was collected to test blood sugar and blood fat before intervention therapy.4 Two parts of elbow venous blood were took in 30 min before stent implantation,2h after stent implantation,10 h after stent implantation and 24 h after stent implantation from each patients in each group.One part of the blood was used to test hs-CRP in clinical laboratory,the other part was placed at room temperature for 2 hours to separate serum.The serum was used to detect CTRP5 concentration by enzyme linked immunosorbent assay.5 The data were analyzed by SPSS22.0 software.The measurement data was showed as mean± standard deviation(x ±s).t test was used to analyze two groups of measurement data,F test was used for analysis of more than two groups of measurement data,chi-square test was used to analyze enumeration data.P < 0.05 was took as statistic significance level.Results:1 In comparison with the level of CTRP5 before stent implantation,the level of CTRP5 continued to rise after intervention therapy in unstable angina pectoris and stable angina pectoris(P<0.05).The CTRP5 level arrived in maximum at 10 h after intervention therapy.The level of CTRP5 in patients with unstable angina pectoris was higher than that in patients with stable angina pectoris regardless of pre-or post-operation(P<0.05).The level of CTRP5 in patients with stable angina pectoris was higher than that in patients in control group at each time regardless of pre-or post-operation(P<0.05).There was no obvious change in the level of CTRP5 in patients in control group after PCI in comparison with that before PCI(P>0.05).2 In comparison with the level of hs-CRP before stent implantation,the level of hs-CRP continued to rise after intervention therapy in unstable angina pectoris and stable angina pectoris(P<0.05).The level of hs-CRP got to the maximum at 10 h after stent implantation.The level of hs-CRP in patients with unstable angina pectoris was higher than that in patients with stable angina pectoris at each time regardless of before and after the operation(P<0.05).The level of hs-CRP in patients with stable angina pectoris was significantly higher than that in control group at each time(P<0.05).There was no significant change of hs-CRP level in patients in control group before and after coronary angiography(P>0.05).Conclusions: The serum level of CTRP5 in patients with unstable angina pectoris increases gradually in 24 h after PCI,Which may participate inthe inflammation after intervention therapy.