| Objective: The correlation between LPa and the severity of coronary atherosclerosis and its prognosis-appraising value were explored by analyzing the plasma level of lipoprotein a(LPa)in patients with coronary atherosclerotic heart disease(CHD)and its relationship with prognosis.Methods: We retrospectively collected and analyzed a total of 762 patients who attended the Department of Cardiology,Affiliated Hospital of Zunyi Medical University and finished CAG for chest pain,chest tightness and other reasons from January 2019 to May 2019.The degree of coronary artery stenosis was judged by QCA measurement on the basis of CAG.Those with stenosis less than 50% were included in the non-CHD group(n=380 cases),and those with stenosis ≥ 50% were the CHD group,which was the study group(n=382 cases).Due to differences in general clinical data and blood lipids between the two groups,the CHD group(n=296 cases)and the non-CHD group(n=296 cases)were screened out after propensity score matching,and the LPa levels of the two groups were compared.At the same time,the Syntax score of each patient was calculated according to the results of the angiography,and the CHD group was divided into mild coronary artery disease group(≤ 22 points,n=288 cases)and moderate to severe coronary artery disease group(> 22 points,n = 94 cases),compare the general clinical data and blood lipids between the two groups.Due to the differences in TC and LDL-C between the two groups,We compared the level of LPa after matching the propensity score,the moderate and severe coronary artery disease group(n=78 cases)and the mild coronary artery disease group(n=78 cases)were screened out.The Spearman rank correlation method was used to analyze the relationship between the severity of coronary artery lesions and LPa.According to the level of LPa,the three-quantile method was used to divide the CHD into the low LPa group(n=127 cases),the medium LPa group(n=128 cases)and the high LPa group(n=127 cases).The adverse cardiovascular events that occurred during the hospitalization of all patients were recorded at the same time,We compared and analyzed the difference in the incidence of in-hospital adverse events among the three groups.Results:(1)Through comparative analysis of the general data of the research subjects,it is found that the CHD group is compared with the non-CHD group in age [(60.53 ± 12.33)vs(56.94 ± 10.13)],gender(male)[283(74.1%)vs 194(51.1)%)],history of smoking [248(64.9%)vs 150(39.5%)],history of hypertension [197(51.6%)vs 149(39.2%)],history of diabetes [40(10.5%)vs 27(7.1%)],LPa[(230.54 ±64.37)vs(129.96 ± 42.54)],TC[(6.29±1.41)vs(5.06 ±0.98)],TG[(2.54 ±0.49)vs(1.87 ±0.61)],LDL-C [(4.31 ± 0.89)vs(2.81 ±0.75)] The CHD group is higher than the non-CHD group,and the HDL-C [(1.01 ±0.33)vs(1.25 ± 0.25)] is lower than the non-CHD group,the difference is Both were statistically significant(P<0.05);The history of hyperlipidemia between the two groups [12(3.1%)vs 10(2.6%)],heart rate on admission [(79.94 ± 15.24)vs(78.43 ± 12.15)],Cr [(71.10± 19.26)vs(75.28 ± 18.64))],UA[(322.1 ± 76.21)vs(349.19 ± 86.95)],the difference was not statistically significant(P > 0.05).In order to further exclude the influence of gender,age,smoking history,history of hypertension,history of diabetes,TC,TG,LDL-C and HDL-C,following propensity score matching and calibration,it was found that the LPa level(206.87 ±65.74)of the CHD group was significantly higher than the LPa level(159.44±47.71)in the non-CHD group,and the difference was statistically significant(P<0.05).(2)There was no difference in comparison significance between the moderate and severe coronary artery disease group and the mild coronary artery disease group is in age [(61.90 ± 12.02)vs(60.08 ±12.42)],gender(male)[69(73.4%)vs 214(74.3%))],history of smoking [65(69.1%)vs 183(39.5%)],history of hypertension [53(56.4%)vs 144(50.0%)],history of diabetes [6(6.4%)vs 34(11.8%)],heart rate [(78.72 ± 20.14)vs(80.33 ± 13.84),while the difference was statistically significant(P < 0.05)in TG[(2.63 ± 0.62)vs(2.51 ± 0.47)],HDL-C [(0.92 ± 0.22)vs(1.03 ± 0.31),TC [(6.45 ± 1.04)vs(6.23 ± 1.38)],LDL-C [(4.47 ± 1.23)vs(4.25 ± 0.94)],and LPa[(238.84 ± 58.63)vs(227.83 ± 46.79)].In order to further exclude the influence of TC and LDL-C,the propensity score matching calibration was carried out,and it was found that the LPa level(235.14±50.27)of the moderate and severe coronary artery disease group was significantly higher than the LPa level of the mild coronary disease group(229.45±43.82),and the difference was statistically significant(P< 0.05).(3)The Spearman rank correlation method was used to analyze the relationship between LPa and the severity of coronary artery disease,and it was found that LPa and Syntax score were positively correlated,but the difference was not statistically significant(rs = 0.428,P > 0.05).(4)When the correlation analysis of LPa level and the occurrence of adverse events in hospital was carried out,it was found that the incidence of high LPa group [25.98%(33)] was higher than that of medium LPa group [ 15.63%(20)] and low LPa [ 7.09%(9)],The incidence rate of the medium LPa group[15.63%(20)] was higher than that of the low LPa group [ 7.09%(9)],and the differences were statistically significant(P < 0.05).Conclusion: LPa is also one of the most important lipid components that cause atherosclerosis.The plasma LPa level is positively correlated with the severity of coronary atherosclerosis and also the higher the plasma LPa level,the higher risk of in-hospital(short-term)adverse events in CHD patients. |
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