Correlation Between Serum Level Of NT-proBNP,Lipoprotein(a) And Severity Of Coronary Lesions In Patients With Acute Coronary Syndrome

Objective:To assay the change in lipoprotein(a)[Lp(a)] and N-terminal of the prohormone brain natriuretic peptide(NT-pro BNP)of acute coronary syndrome(ACS)patients,conjecture the relation between Lp(a),NT-pro BNP and CHD morbidity,coronary heart disease extension,and seek clinical guidelines of evaluating coronary heart disease extension noninvasively.Methods:We choose 172 patients who receive treatment due to chest tightness or pectoralgia and make coronary angiography(CAG)in Shanxi Fenyang Hospital,and group them into lesion group(130 cases)and control group(42 cases)according to coronary angiography results.We also give Gensini scores based on coronary artery lesions,collect general data and check the two groups’ plasma Lp(a)and NT-pro BNP.Independent samples would be chosen for normally distributed measurement data to run T test to compare the differences,while two independent samples would be chosen to run chi-square test for abnormally distributed measurement data.Dual logistic regression would be applied to run multifactorial analysis.Spearman rank correlation is applied to analyze the relation between Gensini score,lesion index and Lp(a).And ROC is used to seek the threshold of the independent influence factor over the patients.Results:Plasma Lp(a)of lesion group is significantly higher than control group,at171.1(300.93)VS90(93.3)mg/L,P<0.05.when a person’s Lp(a)has exceeded 110.3mg/L,he can be diagnosed of the disease with an accuracy of 71.8%.Lp(a)and Gensini scores show a positive correlation,P<0.01.Plasma low density lipoprotein(LDL)of lesion group is significantly higher than control group,(2.95±0.82)VS(2.64±0.80)mmol/L,P<0.05,and a person with LDL higher than 2.615 mmol/L can be diagnosed of the disease,with an accuracy of 61%.There’s no correlation between LDL and Gensini score,P>0.05.The diagnostic value of combining Lp(a)and LDL to predict dieases is no better than Lp(a)alone.Plasma Apolipoprotein A1(Apo A1)of lesion group is significantly lower than control group,(1.11±0.18)VS(1.20±0.18)g/L,P<0.05.Apo A1 shows a negative correlation with the severity of coronary artery lesion.There is no statistic difference of the two groups in NT-pro BNP level,age,gender,smoking status,amalgamate hypertension or not,dyslipidemia,pituitary apoplexy and family history.Conclusion:Lp(a)level is closely related with coronary heart disease,and is a risk factor for coronary heart disease.There is a positive correlation between Lp(a)level and coronary artery disease extension,and with the rising of Lp(a)level,coronary artery disease extension goes more serious.And Lp(a)level can be seen as a index to predict coronary artery heart extension.Speaking of the diagnostic value of coronary heart disease,Lp(a)is better than LDL,which shows no corrrelation with coronary artery disease extension.NT-pro BNP is not a index to predict coronary artery heart extension,which shows no corrrelation with coronary artery disease extension.Apolipoprotein A1 is a protection factor for coronary heart disease,and shows a negative correlation with coronary artery disease extension.Current lipid-lowering medication mainly aims to lower LDL and total cholesterol.Lowering Lp(a)and reducing the oxidation of Apo A1 might be a new method to cure and even prevent coronary heart disease.