Study On The Relationship Between Plasma Angiotensin - Converting Peptide Level And Coronary Atherosclerotic Heart Disease

Part Ⅰ Association between plasma angiotensin peptide levels and coronary artery diseaseObjectiveTo study plasma levels of angiotensin Ⅱ (AngⅡ), angiotensin (1-7) (Ang (1-7)) and angiotensin Ⅰ (AngⅠ) in coronary artery disease (CAD) patients and evaluate their association with clinical data.MethodPlasma level of AngⅡ, Ang (1-7) and AngI were measured in 890 patients with coronary Angiography (CAG), including 776 CAD patients (496 patients with acute coronary syndrome (ACS) and 280 with stable Angina pectoris (SAP)) and 114 controls with negative CAG results. The association between plasma level of AngⅡ, Ang (1-7), AngⅠ and clinical data, the severity of coronary artery lesion and prognosis were investigated.Results1. The association between angiotensin peptide and risk factor of CAD1.1 AngⅡ was positively related with age and uric acid (r=0.267, P<0.001;r=0.146, P=0.018) and negatively related with high density lipoprotein cholesterol(r=-0.081, P=0.021). AngⅡ level of hypertension patients was higher compared with normotensive ones (35.91(22.08,49.05) pg ·ml-1 versus 31.51(18.78,44.40) pg·ml-1, P=0.005). AngⅡ level of smokers was higher compared with non-smokers (34.50(22.20,48.16) pg·ml-1 versus 32.40 (20.24,44.88) pg·ml-1, P=0..039).1.2 Ang(1-7) was positively related with total cholesterol and triglyceride (r=0.091, P=0.009;r=0.134,P<0.001), and negatively related with age and OGTTOh (r=-0.097, P=0.004; r=-0.145, P=0.004).1.3 AngI was positively related with total cholesterol, triglyceride and BMI (r=0.096, P=0.006;r=0.151,P<0.001;r=0.078, P=0.027) and negatively related with OGTTOh(r=-0.118, P=0.021).2. The association between angiotensin peptide and CAD and its type.2.1 Levels of AngⅡ was higher in CAD group compared with the control group (34.32 (21.26,47.82) pg·ml-1 versus 27.92 (15.42,39.53) pg·ml-1 ,P=0.001) and AngⅡ was an independently related with CAD (OR 1.201 95%CI 1.044-1.382 P=0.010).2.2 Level of Ang(1-7) was higher in CAD group compared with the control group (107.67 (50.90,200.93) pg·ml-1 versus 76.00(36.94,168.51) pg· ml-1, P=0.035). Level of Ang(1-7) was higher in ACS patients compared with SAP patients (111.68(52.28,207.56) pg·ml-1 versus 96.61 (42.95,186.68) pg ·ml-1,P=0.011).2.3 Level of AngI was higher in CAD group compared with the control group (116.04,360.02) pg·ml-1 versus 150.32(95.57,260.39) pg·ml-1, P=0.001)and AngI was an independently related with CAD (OR 1.264 95%CI 1.097-1.457 P=0.001). Level of AngⅠ was higher in ACS patients compared with SAP patients (225.71(119.97,381.21) pg·ml-1 versus 195.04(94.75,331.85) pg·ml-1,P=0.008), and AngI was an independently related with ACS (OR 1.163 95%CI 1.064-1.271 P=0.001)3. The association between angiotensin peptide and the severity of coronary artery lesion3.1 Level of AngⅡ was higher in patients with three-vessel lesions compared with those with one or two vessel lesions (35.76(22.37,49.05) pg·ml-1 versus 32.41(19.83,47.12) pg·ml-1, P=0.003). In CAD group, AngⅡ was positively related with Gensini score(r=0.080, P=0.026).3.2 Level of Ang(1-7) was lower in three-vessel lesions group compared with those with one or two vessel lesions (87.95(40.64,179.39) pg·ml-1 versus 112.05 (59.46,201.49) pg·ml-1, P=0.013).3.3 Level of AngI was lower in three-vessel lesions group compared with those with one or two vessel lesions (177.69(81.15,292.87) pg·ml-1 versus 220.52(126.14,365.64) pg·ml-1, P<0.001) and AngI was independently related with number of lesion (OR 0.895 95%CI 0.826-0.970 P=0.007).4. The association between angiotensin peptide and prognosis of CAD4.1 In patients with elective percutaneous coronary intervention(PCI), level of Ang II was higher in patients who had in-hospital adverse cardiac events compared with those who did not(41.42(28.73,57.07) pg·ml-1 versus 35.66(22.84,48.22) pg·ml-1, P=0.009). Ang Ⅱ level was an independent risk factor of in-hospital adverse cardiac events (OR 1.204 95%CI 1.058-1.369 P=0.005).Conclusions1. Plasma level of AngⅡ is positively related with age and uric acid and negatively related with high density lipoprotein cholesterol. Plasma level of Ang (1-7) is positively related with total cholesterol and triglyceride and negatively related with age and OGTTOh.. Plasma level of AngI is positively related with total cholesterol, triglyceride and BMI and negatively related with age and OGTTOh.2. Plasma level of AngⅡ is independently associated with CAD. Plasma level of AngI is independently associated with CAD and ACS.3. Plasma level of AngⅡ has a positive relationship with the severity of coronary artery lesions. AngI was independently related with number of lesion.4. Plasma level of Ang Ⅱ is negatively correlated with in-hospital prognosis of patients who have experienced elective PCI.Part Ⅱ Association between plasma cysteine-rich protein 61(CYR61) levels and coronary artery diseaseObjectiveTo study plasma level of cysteine-rich protein 61 (CYR61) in coronary artery disease (CAD) patients and evaluate their association with clinical data.MethodPlasma level of CYR61 was measured in 97 patients with CAD (48 patients with acute coronary syndrome (ACS) and 49 with stable Angina pectoris (SAP)) and 49 controls with negative CAG results. The association between plasma level of CYR61 and clinical data was investigated.ResultsPlasma levels of CYR61 were higher in patients with CAD (4546.76 (3469.12, 7062.50) pg·ml-1 versus 10472.43 (6317.87,16699.65) pg·ml-1, P<0.001) and CYR61 was an independent risk factor of coronary artery disease (OR 1.181 95%CI 1.088～1.282 P<0.001). CYR61 levels in ACS group were significantly higher than those in SAP group (8029.82(5616.99,11192.63) pg·ml-1 versus 15612.50 (8906.25,26215.58) pg·ml-1, P<0.001). CYR61 was positively related with Gensini score (r=0.387, P<0.001).Conclusions1. Plamsa level of CYR61 is independently associated with CAD.2. Plamsa level of CYR61 is positively associated with the severity of coronary artery lesions.