Clinical Application Of CYR61 In Risk Stratification Of ASCVD

Objective:Atherosclerotic Cardiovascular Disease(ASCVD)has a high incidence rate and mortality rate in China.At present,there is still controversy about predicting the probability of future ASCVD according to the risk stratification of ASCVD.A large number of studies show that chronic inflammation is involved in its occurrence and development.Cysteine rich protein 61(CYR61),as a novel inflammatory marker,can promote the release of various inflammatory factors,participate in tissue damage,and promote the adhesion,proliferation,migration,survival,and angiogenesis of human microvascular endothelial cells,At the same time,it can also block blood vessels,accelerate the formation of atherosclerosis,cause plaque instability,and lead to plaque rupture and thrombosis through inflammatory reaction,up regulation of coagulation promoting factors and other ways.So far,research on the risk stratification of CYR61 and ASCVD is still in a blank stage.This project mainly studies the differential expression of CYR61 in ASCVD risk stratification population and CAD patients,and explores whether it can predict the probability of future ASCVD incidence in patients.Methods:This study screened a total of 291 patients from Kunming First People’s Hospital from December 2021 to January 2023(physical examination:hospitalization=2.29:1),including 132 males and 159 females,with an age range of 18-96 years old and an average of 47 years old.Among them,there are 136 ASCVD risk stratification individuals,including 60 males and 76 females,with an age range of 18-67 years old and an average of 39 years old;There are 119 people in the ASCVD disease group,including 76 males and 43 females,with an age range of 41-96 years old and an average of 65 years old;A healthy control group was selected from a group of 36individuals who did not smoke,drink alcohol,or have special diseases during the same period,including 14 males and 22 females,with an age range of 18-38 years old and an average of 28 years old.Extract fasting blood from the enrolled population and place it in a 4000r/min centrifuge for 15 minutes.Take patient serum 500μL completed GLU,TC,HDL-C,LDL-C detection on ADVIA Chemistry XPT biochemical analyzer,and used Elisa methodology(double antibody sandwich method)to detect CYR61 concentration in the remaining serum of patients.The SPSS version 21.0 was used to describe and analyze the data.The normality test of the measurement data was determined using the 1-Sample K-S Test(K-S).Spearman rank correlation analysis was used to clarify the basic situation of each group of patients and the relationship between CYR61 and ASCVD risk factors.Logistic regression analysis was used to explore the role of CYR61 in the disease,and diagnostic analysis was performed on ASCVD risk stratification groups using the receiver operating curve(ROC),α=0.05 as the test level,P<0.05 has statistical significance.Results:1.Basic characteristics of study subjects:(1)ASCVD risk stratification Basic characteristics of study subjects:The results showed inter group differences in systolic blood pressure,GLU,diastolic blood pressure,TC,HDL-C,LDL-C,CYR61,BMI,age,smoking,DM,and gender(p<0.05),with Z/F/X~2values of 87.9,83.9,and21.3、77.2、85.1、88.0、84.7、86.0、65.0、32.7、57.3、8.0,respectively。(2)Basic characteristics of ASCVD disease group research subjects:The results showed inter group differences in LDL-C,CYR61,gender,and smoking(p<0.05),with Z/F/X~2of6.6,24.2,14.4,and 14.0,respectively.There was no inter group correlation in age,systolic blood pressure,diastolic blood pressure,GLU,TC,HDL-C,BMI,and DM(p>0.05).2.Differential expression of CYR61 in ASCVD risk stratification and disease groups:The results showed that the concentration of CYR61 in the control group,low-risk group,medium risk group,and high-risk group was 0.3ng/m L,04ng/m L,0.6ng/m L,and 0.8ng/m L,with intergroup differences(p<0.05).The concentrations in SAP,UAP,and AMI were 0.9ng/m L,1.2ng/m L,and 1.9ng/m L,respectively,with intergroup differences(p<0.05).3.Correlation between CYR61 and ASCVD risk stratification:(1)Spearman correlation analysis between CYR61 and ASCVD risk stratification showed that there was an inter group difference between CYR61 and ASCVD risk stratification,p<0.05,with an r value of 0.700.(2)The correlation analysis between CYR61 and risk factors showed that there was a significant correlation between CYR61 and gender,age,systolic blood pressure,diastolic blood pressure,DM,smoking,TC,HDL-C,LDL-C,BMI,GLU(p<0.05),with r values of 0.261,0.576,0436,0.345,0.407,0.354,0.547,-0.231,0.520,0.229,and 0.295,respectively The regression analysis results showed that after incorporating CYR61 and its related indicators into the risk stratification of ASCVD,it was found that CYR61 and TC had statistical significance(p<0.05),with regression coefficients of 3.342 and 0.579,and OR values of 28.284 and 1.785,respectively.4.Application evaluation of CYR61 in ASCVD risk stratification:The diagnostic evaluation results of CYR61 in ASCVD risk stratification showed that the AUC of the low risk group,medium risk group,and high risk group were 0.839,0787,and 0.804,respectively.The cut off values were 0.480,0.490,and 0.610,respectively,the sensitivity scores were 0.821,0.750,and 0.750,respectively,the specificity scores were 0.800,0.821,and 0.750,respectively,and the coincidence rates were 93.382%,91.304%,and 74.265%,respectively.The positive predictive values were 88.525%,96.667%,and 57.895%,respectively,The negative predictive values were 97.333%,88.710%,and 86.076%,respectively,and the Jordan index was 0.800,0.821,and0.500,respectively.Conclusion:1.CYR61 may be a good indicator for predicting ASCVD risk stratification.2.The expression level of CYR61 varies in each group of ASCVD risk stratification,and the concentration of CYR61 gradually increases as the risk level of ASCVD risk stratification increases.3.The expression level of CYR61 varies among CAD groups,and the concentration of CYR61 gradually increases as the disease progresses.