| Objective:To explore the correlation between soluble low density lipoprotein receptor related protein-1(sLRP-1),monocyte / lymphocyte ratio(MLR)and acute coronary syndrome(ACS),and to explore new inflammatory markers to assist in disease diagnosis and evaluation of disease-related conditions.Methods:A total of 294 patients who underwent coronary angiography(CAG)in the Department of Cardiology of our hospital from June 2019 to January2020 met the inclusion criteria.The general data and clinical data of the patients were collected,the degree of coronary artery disease was evaluated by Gensini score system,and the concentration of sLRP-1 was detected by enzyme-linked immunosorbent assay(Elisa).According to the clinical diagnosis and the results of CAG,the patients were divided into two groups:ACS group and control group,ACS group with an average age of 59.34±9.68 years,and control group of 99 cases,including 31 males and 68 females with an average age of 57.08 ±9.14 years.According to Gensini score,patients in ACS group were divided into low score group and high score group,including 98 patients with mild stenosis,69 males and 29 females,with an average age of 59.43 ±9.64 years,and 97 patients with severe lesions,75 males and 22 females,with an average age of 59.26 ±9.77 years.The correlations between the levels of serum sLRP-1 and MLR and the clinical diagnosis and the degree of coronary artery disease were compared.SPSS 26.0 was used for statistical analysis.The difference was statistically significant(P < 0.05).Results:1.Baseline characteristics of ACS group and control group: compared with the control group,the proportion of male,smoking,hypertension and type 2 diabetes mellitus in ACS group were higher,which were(73.8% vs31.3%,56.9% vs 20.2%,57.9% vs 42.4%,24.1% vs 9.1%,respectively).The difference was statistically significant.Compared with the control group,the platelet count,systolic blood pressure,white blood cells,neutrophils,lymphocytes,monocytes,high density lipoprotein cholesterol,low density lipoprotein cholesterol,MLR and sLRP-1 were significantly higher in ACS group.2.The analysis of ROC curve showed that the best critical value of sLRP-1 for predicting ACS was 2.00ug/ml,the sensitivity was 53.3%,the specificity was 75.8%,and the area under the curve was 0.673[95%CI(0.611-0.734),P < 0.001].The best critical value of MLR for predicting ACS is 0.18,the sensitivity is 95.4%,the specificity is 38.4%,and the area under the curve is 0.698 [95%CI(0.632-0.765),P < 0.001].Multivariate Logistic regression analysis showed that the increase of sLRP-1 and MLR were independent risk factors for ACS(OR=3.389,P=0.001;OR=5.929,P<0.001).3.The levels of sLRP-1 and MLR were positively correlated with the degree of coronary artery disease(r = 0.369,P<0.001;r=0.272,P<0.001).4.The analysis of ROC curve showed that the best critical value of sLRP-1 for predicting severe coronary artery disease was 4.14ug/ml,the sensitivity was 47.4%,the specificity was 86.7%,and the area under the curve was 0.701 [95%CI(0.627～0.775,P<0.001].The best critical value of MLR for predicting severe coronary artery disease was 0.30,the sensitivity was 54.6%,the specificity was 65.3%,and the area under the curve was0.626 [95%CI(0.548-0.704),P=0.002].Univariate Logistic regression analysis showed that sLRP-1 ≥ 4.14ug/ml and MLR ≥ 0.3 were risk factors for the severity of coronary artery disease(OR=5.897,P<0.001;OR=2.095,P=0.012).Multivariate Logistic regression analysis confirmed that sLRP-1 ≥4.14ug/ml was an independent risk factor for the severity of coronary artery disease(OR=5.154,P<0.001).Conclusion:1.Compared with non-coronary heart disease group,the levels of sLRP-1 and MLR in ACS group were significantly higher,and the difference was statistically significant.They are independent risk factors of ACS,have important value in identifying patients with acute coronary syndrome,and can be used as effective inflammatory markers of ACS.2.The levels of sLRP-1 and MLR are statistically different in different lesion degree groups,which are positively correlated with the degree of coronary artery disease.They are the risk factors of coronary artery disease in patients with ACS,and have certain clinical significance in predicting the degree of coronary artery disease. |
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