| Objectives To discuss the relationship between the levels of Lp-PLA2 and the number and the severity of the coronary artery lesions in patients with ACS who were investigated,the coronary angiography was performed on patients with acute coronary syndrome(ACS),they were all determined plasma lipoprotein-associated phospholipase A2(LpPLA2)levels.Methods 137 patients who underwent coronary angiography(CAG)at the Tangshan Gongren Hospital from January to December in 2017 were selected and divided into acute coronary syndrome group(n=97)and control group(n=40)according to coronary angiography results.The acute coronary syndrome group was divided into two subgroups of unstable angina(UAP)and acute myocardial infarction(AMI)according to clinical types;The Gensini scores were calculated based on the angiographic results of all patients,and ACS patients were also divided into three groups according to the interquartile range of Gensini scores.The 0-41 was defined mild group,the 42-82 was defined moderate group,and the 83-124 was defined severe group.The highest Gensini score in the selected cases was 124 points.All of the selected patients signed informed consent and the plasma Lp-PLA2 levels were measured by enzyme-linked immunosorbent assay.Clinical datas such as gender,age,the history of diabetes,the history of hypertension,and the history of smoking were collected along with total cholesterol,triacylglycerol,and high-density lipoprotein cholesterol(HDL-C),Low-density lipoprotein cholesterol(LDL-C),apolipoprotein-A1(apo A1),apolipoprotein-B(apo-B),lipoprotein(a),alanine aminotransferase(ALT),aspartate aminotransferase(Laboratory data such as AST,urea nitrogen,creatinine,NT-pro BNP,and homocysteine(Hcy).Results 1 Plasma Lp-PLA2 levels in the ACS group were higher than those in the control group [(135.98±36.04)μg/L ratio(47.45±22.82)μg/L,P<0.05];plasma Lp-PLA2 levels in the UAP and AMI subgroups were higher than those in the control group and the differences were statistically significant [(128.14±32.20),(143.05±38.12)vs.(47.45±22.82)μg/L,all P<0.05];the plasma levels of Lp-PLA2 in the AMI subgroup were higher than those in the UAP subgroup.However,there was no significant difference between UAP and AMI subgroups(P>0.05).2 In the ACS group,with the increasing of the number of lesions and Gensini scores,plasma Lp-PLA2 levels gradually increased.The levels of LpPLA2 in the sub-groups of single,double,and triple vessels of the diseased coronary artery were higher than the control group,the difference was statistically significant [The number of lesions in the coronary arteries of single,double,or triple vessels(101.47±12.22),(127.62±19.05),(168.60±31.34)μg/L ratio(47.45±22.82)μg/L];According to the Gensini score,all the patients were divided into three groups: the light group,the moderate group,and the severe group.There was no difference in the levels of age,Fbg,TC,TG,HDL-C,LDL-C,Apo A1,ALT,AST,HCY,and NT-pro BNP in each group(P>0.05);Plasma LpPLA2 levels in the severe group were significantly higher than those in moderate group and mild group;Lp-PLA2 levels in the moderate group were significantly higher than those in mild group,and the differences were statistically significant(P<0.05).3 Pearson correlation analysis showed that plasma Lp-PLA2 levels were positively correlated with ALT,AST,and Gensini scores in the ACS group(r=0.241,0.215,0.515,P<0.05),and negatively correlated with Apo A1(r=-0.219,P<0.05).There is no significant correlation between plasma Lp-PLA2 levels and age,Fbg,TC,TG,HDL-C,LDL-C,Apo-B,Lp(a),BUN,CRE,LDH,CK,CK-MB,NT-pro BNP and HCY(r=0.052,0.024,-0.068,-0.120,-0.114,0.002,0.023,-0.099,-0.008,0.169,0.165,0.147,0.045,0.133,0.179).4 Plasma Lp-PLA2,AST and NT-pro BNP were independently associated with Gensini scores and they could be used as independent risk factors for Gensini scores.The cut-off value of plasma Lp-PLA2 in ACS patients was 87.82 μg/L.Conclusions 1 Plasma Lp-PLA2 levels are significantly elevated in coronary heart disease patients with ACS,which can indirectly show the severity of coronary artery disease.2 Plasma Lp-PLA2 was positively correlated with ALT,AST,and Gensini scores and it was negatively correlated with Apo A1.3 Plasma Lp-PLA2,AST and NTpro BNP can be used as relevant factors to Gensini score. |
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