Research On The Relationship Between Cysteine-rich Protein 61 In Serum And The Formation Of Coronary Collateral Circulation

Objective:To observe the expression of cysteine-rich protein 61(CYR61)in patients with coronary heart disease,analyze its role and clinical significance in the formation and development of coronary collateral circulation(CCC),and to discuss the effect of CYR61 on the formation of CCC.Methods:This research took the case-control research methods.We collected 110 patients who were hospitalized in the cardiovascular department of Loudi central hospital from March 2020 to January 2021 because of chest tightness,chest pain or chest discomfort,and these patients underwent selective coronary angiography(CAG)for the first time which showed that at least one of the three main coronary arteries(left anterior descending artery,left circumflex artery and right coronary artery)had a degree of stenosis ≥ 95%.At the same time,according to the Rentrop grading method,we judged the situation of the formation of CCC and divided them into two groups:(1)no collateral circulation formation group(Rentrop 0,n=45);(2)collateral circulation formation group(Rentrop 1-3,n=65),which included 19 cases in Rentrop 1,20 cases in Rentrop 2,26 cases in Rentrop 3.We collected and recorded the basic clinical data of each selected patient,and detected the concentration of CYR61 in serum by enzyme-linked immunosorbent assay.We analyzed the data by SPSS 25.0,when p<0.05 indicates that the difference is statistically significant.Results: 1.Compared the no collateral circulation formation group and the collateral circulation formation group,the two have significant difference(p<0.05)in serum CYR61 level,Gensini score,and the number of diseased blood vessels,but have no significant difference(p>0.05)in the baseline data and the other basic laboratory test results.2.There was significant difference in the level of serum CYR61 among patients with different Rentrop grades(p < 0.05),The level of CYR61 was the lowest Rentrop 0 and the highest in the Rentrop 3,and there was significant difference between the two(p<0.001),but there was no significant difference between the other groups(p>0.05).3.Spearman correlation analysis showed that CYR61 level was positively correlated with the classification of coronary collateral circulation(r=0.40,p < 0.001).Gensini score was positively correlated with the classification of coronary collateral circulation(r=0.36,p<0.001).4.Multivariate Logistic regression analysis showed that CYR61(OR=1.001,p=0.021)was the influence factor of the formation of coronary collateral circulation.The Gensini score(OR=1.025,p=0.005)is also an influence factor of the formation of coronary collateral circulation.5.The area of CYR61 under the ROC curve is 0.708,(95%CI:0.606-0.811,p < 0.001).When CYR61 takes 1932.94 pg/ml,the Youden index is the highest,and it predicts the sensitivity of the coronary collateral circulation formation is 86.2%,the specificity is 53.3%.The area of Gensini score under the ROC curve is 0.719,(95% CI: 0.625-0.814,p<0.001).When the Gensini score reached 81,the Youden index was the highest,and it predicts the sensitivity of the coronary collateral circulation formation is 67.7%,and the specificity is 68.9%.Conclusion: Serum CYR61 may be associated with coronary collateral circulation formation and it may be have potential value in predicting the formation of coronary collateral circulation.