The Study On Relation Of Lipoprotein-associated Phospholipase A2 And Tricuspid Annular Plane Systolic Excursion With Acute Coronary Syndrome

[Research background] The morbidity rate and mortality rate of cardiovascular diseases(CVD)in the world is still a widespread concern in the field of medical and health.Acute coronary syndrome(ACS)are a very high-risk type of CVD.Lipoprotein-associated phospholipase A2(LP-PLA2)is an inflammatory mediator found to play an important role in the development of ACS.It is particularly important to study the relationship between LP-PLA2 with ACS for early assessment and intervention of ACS.Right ventricular function is closely related to many CVD,tricuspid annular plane systolic excursion(TAPSE)is an common indicator reflecting right ventricular systolic function,and right ventricular function evaluation is of great significance.[Object]1.To discuss the correlation between LP-PLA2 level and ACS;2.To discuss the relationship between LP-PLA2 and severity of coronary lesion in patients with ACS;3.To discuss the relationship between LP-PLA2 and right ventricular systolic function in patients with ACS.[Method] 220 selected patients hospitalized in the Department of Cardiovascular Medicine of Huizhou Third People’s Hospital from March 2019 to December 2019 were divided into ACS group(n=182)and control group(coronary angiography(CAG)showed that the stenosis diameter was less than 50%)(n=38)according to symptoms,related clinical indicators and the results of coronary angiography.ACS group was divided into unstable angina pectoris(UA)group(n=82)and acute myocardial infarction(AMI)group(n = 38).AMI group was divided into ST-segment elevation myocardial infarction(STEMI)group(n=64)and non-ST-segment elevation myocardial infarction(NSTEMI)group(n=36)according to ECG pathological location,and STEMI group was divided into acute anterior and/or lateral myocardial infarction group(n=34)and acute inferior and/or right ventricular myocardial infarction group(n=30).According to the results of CAG,ACS group was divided into three-branches lesion group(n=79)and non-three-branches lesion group(n = 103).According to Gensini score of coronary artery,ACS group was divided into 0-39 group(n=66)and ≧40 group(n=74).Plasma LP-PLA2 level was measured by continuous detection within 24 hours after admission in all patients,and the TAPSE was measured by Color Doppler machine,And collect basic clinical data and other clinical indicators.All the data were processed and analyzed by SPSS 20.0,and the difference was statistically significant with P<0.05.[Result] The levels of LP-PLA2 in AMI group(421.72±122.75 U/L)and UA group(416.02±110.00 U/L)were significantly higher than those in control group(333.03±87.17U/L)(P< 0.001).The level of LP-PLA2 in NSTEMI group(472.69±84.87)was higher than that in STEMI group(393.04±106.50 U/L)(P< 0.001).The more the branches of coronary lesion and the higher the coronary Gensini score,the higher the LP-PLA2 level(P<0.05).Logistic regression analysis showed that LP-PLA2 was an independent risk factor for ACS(P<0.001),and multiple stepwise regression analysis showed that LP-PLA2 level was independently correlated with coronary Gensini score P<0.001).The TAPSE of ACS group,control group,acute anterior wall and/or lateral wall myocardial infarction group and acute inferior wall and/ or right ventricular myocardial infarction group were 22.49±3.27,20.91±2.70,20.68±3.41,8.66±2.24 mm,respectively.the TAPSE level in ACS group was higher than that in control group(P<0.05).[Conclusions]1.LP-PLA2 is an independent risk factor of ACS,which is partly related to the occurrence of ACS;2.LP-PLA2 level is positively associated with the severity of coronary lesions in patients with ACS.3.Plasma LP-PLA2 level in patients with ACS may be partly correlated with its right ventricular systolic function.