The Correlation Between IL-6/LDL-C,IL-6/RC And The Risk Degree Of Acute Coronary Syndrome

Background:Blood lipids and inflammation play a key role in atherogenesis.Studies have shown that high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),low-density lipoprotein cholesterol(LDL-C)and residual cholesterol(RC)can independently predict the risk of cardiovascular disease and prognosis.However,these single markers have limited ability to predict risk for acute coronary syndrome(ACS).Therefore,the search for new biomarkers to assess the risk of cardiovascular disease has important clinical value.Objective:The aim of this study is to explore the correlation between the combination of IL-6,inflammation and lipid(IL-6/LDL-C,IL-6/RC)and the risk of ACS,and to compare the diagnostic value with hs-CRP,LDL-C or IL-6.Methods:A total of 211 patients with clinically diagnosed ACS who were treated in the Department of Cardiology of Zhujiang Hospital of Southern Medical University from July 2021 to December 2022 were included in this study.After exclusion criteria,200 ACS patients were finally included in the analysis.According to electrocardiogram and myocardial injury markers,these patients were divided into ST-segment elevation myocardial infarction(STEMI)(n=63),non-ST-segment elevation myocardial infarction(NSTEMI)(n=41)and unstable angina(UA)(n=96).According to TIMI risk score,the patients were divided into three groups:low risk group(49 cases),intermediate risk group(71 cases)and high risk group(80 cases).By comparing the general data and related indicators among the three groups,multivariate ordinal logistic regression analysis was used to find out the factors affecting the risk degree of ACS.The above patients were further divided into low-moderate risk group(120 cases)and high risk group(80 cases).ROC curve analysis was used to explore the diagnostic value of hs-CRP,LDL-C,IL-6,IL-6/LDL-C,IL-6/RC and other factors in evaluating the risk of ACS.Results:There were significant differences in ACS type,antiplatelet medication history,severe coronary stenosis,body mass index(BMI),heart rate(HR),troponin T(TnT),total cholesterol(TC),triglyceride(TG),LDL-C,RC,IL-6,hs-CRP,serum creatinine(SCr),N-terminal pro-B-type natriuretic peptide(NT-pro)among the three groups BNP),IL-6/LDL-C,IL-6/RC,and the difference was statistically significant(P<0.05).The LDL-C level of the high-risk group was higher than that of the low-risk group(P<0.05).There were significant differences in hs-CRP,IL-6,IL-6/LDL-C and IL-6/RC between any two groups(P<0.05).Multivariate ordinal logistic regression analysis showed that smoking history,hypertension,diabetes,severe coronary artery stenosis,age,BMI,TnT,LDL-C,IL-6,hs-CRP,IL-6/LDL-C,IL-6/RC(P<0.05,B>0)were risk factors for ACS patients.And there is a positive correlation.ROC curve analysis showed that hs-CRP,LDL-C,IL-6,IL-6/LDL-C,IL-6/RC(all P<0.05),indicating that the above variables can accurately diagnose the risk degree of ACS patients.The area under the curve(AUC)showed that IL-6,IL-6/LDL-C,IL-6/RC(AUC=0.910,0.949,0.919)had higher diagnostic value than hs-CRP,LDL-C(AUC=0.809,0.905)in predicting the risk of ACS patients.The results of Youden index showed that when the IL-6 value was 8.45 mmol/L,it was the best to distinguish the low,medium and high risk ACS patients,with a sensitivity of 80.3%and a specificity of 85.3%.When the ratio of IL-6/LDL-C was 3.17,the sensitivity was 82.3%and the specificity was 87.5%.When the IL-6/RC value was 16.11,the sensitivity was 84.8%and the specificity was 81.7%.Conclusion:(1)IL-6/LDL-C and IL-6/RC are positively correlated with the risk of ACS.(2)IL-6/LDL-C and IL-6/RC can be used as effective indicators to predict and evaluate the risk of ACS,which has certain value for clinical ACS risk assessment and treatment plan adjustment.