Correlation Analysis Of CD4~+,CD8~+,CD4~+/CD8~+ In Peripheral Blood With Acute Coronary Syndrome

Objective:By investigating the level of CD4~+T and CD8~+T lymphocytes and CD4~+/CD8~+in peripheral blood of patients with acute coronary syndrome(ACS)before and afterpercutaneous coronary intervention(PCI),we understand the changing trend of T cells in ACS and to study its predictive effect on major adverse cardiovascular events(MACE),providing clinical significance.Methods:234 patients hospitalized in department of cardiology,Yanbian University Hospital from September 2019 to June 2021 were recruited,all of whom had signedinformed consent.All patients were classified into Acute coronary syndrome(ACS)group(n=133)and the control group(n=101)based on coronary angiography(CAG)results.The ACS group with unstable angina pectoris(UAP)group(n=21)and acute myocardial infarction(AMI)group(n=112),All the subjects were invited for a coronary angiography,using the sum of the Syntax scores to assess the severity of coronary artery stenosis.The levels of CD4~+T and CD8~+T lymphocytes and CD4~+/CD8~+ratio in peripheral blood of patients in each group were detected by flow cytometry,and the biochemical indexes such as blood routine,liver function,renal function,blood glucose,blood lipid andhigh-sensitivity C-reactive protein were recorded.Patients in the AMI group were followed up,and major adverse cardiac events(MACE)occurred within 1 year after discharge were recorded.Results:1.Compared with the control group,there were statistically significant differences in gender,number of smokers,prevalence of hypertension,prevalence of diabetes,CREA,UA,HS-CRP and HDL-C levels in ACS group(p<0.05),but no significant differences in age,body mass index,CHO,TG,LDL-C and HBA1C(p>0.05).2.Compared with the control group,The level of CD4~+T,CD4~+/CD8~+ratio in ACS group was significantly increased(p<0.05),CD8~+T level was significantly decreased(p<0.05).AMI group compared with the control group,The level of CD4~+T,CD4~+/CD8~+ratio in AMI group was significantly increased(p<0.05),CD8~+T level was significantlydecreased(p<0.05).UAP group compared with control group,CD4~+T and CD4~+/CD8~+ratio level was significantly increased(p<0.05),CD8~+T level had no significant change(p>0.05).AMI group compared with UAP group CD8~+T level was significantly decreased(P<0.05),CD4~+/CD8~+ratio level was significantly increased(p<0.05),CD4~+T level had no significant change(p>0.05).3.In the AMI group,7 days after PCI compared with before surgery,CD4~+T and CD4~+/CD8~+ratio levels decreased significantly(p<0.001),CD8~+T levels were significantly increased(p<0.001).In the UAP group,7 days after PCI compared with before surgery,CD4~+T and CD4~+/CD8~+ratio level decreased significantly(p<0.01),CD8~+T level had no significant change(p>0.05).4.Spearman correlation analysis showed that Syntax score was correlated withpreoperative CD4~+/CD8~+ratio,gender,smoking history,incidence of diabetes,CREA,UA,HS-CRP and HBA1C level were positively correlated(p<0.05),while negativelycorrelated with HDL-C.Age,incidence of hypertension,BMI,CHO,TG,LDL-C andpreoperative CD4~+T and CD8~+T lymphocyte level had no significant correlation(p<0.05).5.Multivariate Logistc regression analysis showed the prevalence of diabetes,smoking history,and preoperative CD4~+T,preoperative CD4~+/CD8~+,Hs-CRP(mg/L)and HBA1C levels had significant positive influence on ACS(p<0.05).Preoperative CD8~+T cell level had no significant influence on ACS(p<0.05).6.ROC curve analysis showed that in AMI patients CD4~+/CD8~+ratio level on the 7th day after PCI had certain predictive value for MACE(p<0.05),the area under curve was0.658(95%CI:0.555-0.762),the optimal critical value was 0.325,the sensitivity was70.8%,the specificity was 61.7%.Conclusion:The level of CD4~+,CD8~+,CD4~+/CD8~+ratio in peripheral blood are related to the pathogenesis and prognosis of ACS.The level of CD4~+/CD8~+ratio was positivelycorrelated with the degree of coronary artery stenosis.In AMI patients,CD4~+/CD8~+ratio level is expected to be a predictive marker of MACE.The level of CD4~+/CD8~+ratio in peripheral blood can be used as a new marker for diagnosis,prognosis and prediction of ACS.