The Study Of Plasma Visfatin, Resistin And Leukotriene-B4 Levels In CHD Patients And Their Correlations To Unstable Plaque Of Acute Coronary Syndrome

Objective:In order to investigat the pathogenesis and clinical detection methods of acute coronary syndrome,through measuring plasma Visfatin,Resistin and Leukotriene-B4 levels,to explore clinical significance of these proinflamatory factors in unstable plaque of acute coronary syndrome.Some patients underwent 64-slice spiral computed tomography coronary artery imaging,to evaluate the clinical value of 64-slice spiral computed tomography combined plasma Visfatin,Resistin and Leukotriene-B4 in the detection of the unstable plaque of acute coronary syndrome.Methods:400 patients which involved CHD group(n=310) and control group (n=90) were enrolled in our study,all patients underwent the Coronary Angiography (CAG) and were confirmed to have or not CHD.According to the clinical characteristics,CHD group was further divided into stable angina pectoris(SAP) group(n=93) and acute coronary syndrome(ACS) group(n=217).In addition, according to the extent of coronary lesion,CHD group was further divided into single, double,three blood vessels lesions group;meanwhile according to the degree of coronary lesion,CHD group was further divided into mild,moderate,severe disease group,according to the standard of ACC/AHA coronary changes m 1988,CHD group was divided into A-type,B-type,C-type disease group.The quantitative assess of the extent of coronary artery disease was made according Gensini score standards.The plasma concentrations of Visfatin,Resistin and Leukotriene-B4 were measured by Enzyme-linked immunosorbent assay(ELISA).85 cases of coronary heart disease patients(including 51 cases of ACS group,34 cases of SAP group were) underwent 64-slice spiral computed tomography coronary artery imaging.Results(1) Soft plaque incidence of ACS group was significantly higher than SAP group,the difference was statistically significant(P＜0.001 ).(2) Compared with control group,the plasma Visfatin,Resistin and Leukotriene-B4 concentration in ACS,SAP group increased,and ACS was higher than SAP group,there were statistically significant difference(P＜0.001).(3) Visfatin,Resistin and Leukotriene-B4 levels were statistically significant difference(P＜0.001) in single,double,three lesions group compared with control group.As the lesions extent,the severity of coronary artery disease increased,Visfatin,Resistin and Leukotriene-B4 levels increased more obviously. (4) Visfatin,Resistin and Leukotriene-B4 levels were statistically significant difference(P＜0.001 ) in A-type,B-type,C-type lesions group compared with control group.(5) In CHD patients,compared with calcified plaque group,plasma Visfatin,Resistin and Leukotriene-B4 levels of soft plaque and the fibrous plaque group were significantly increased(P＜0.05).(6) Multiple linear regression analysis demonstrated that plasma Visfatin,Resistin and Leukotriene-B4 levels positively correlated with Gensini score (Beta value for Visfatin,Resistin and Leukotriene-B4 were 0.413,0.233,0.181,respectively), suggested that Visfatin,Resistin and Leukotriene-B4 were non-traditional risk factors for CHD.(7) To logistic regression analyze between CHD and its risk factors,suggested that hypertension,hyperlipidemia,male,smoking were risk factors for serious Coronary artery disease.Conclusions1.The activity of inflammatory response increases in patients With CHD.The expression of various proinflammatory factors were related with the degree of atherosclerosis,which are participated in the incidence and development of coronary heart disease.2.The measurement of the plasma Visfatin,Resistin and Leukotriene-B4 concentration, may elevate the accuracy of 64-slice spiral computed tomography to detect atherosclerosis plaque's status in patients with CHD,and improve the diagnosis rate of acute coronary syndrome.3.Visfatin,Resistin and Leukotriene-B4 are independent untraditonal risk factors of CHD,their plsma levels are significantly associated with CHD,particularly ACS.4.The plasma Visfatin,Resistin and Leukotriene-B4 concentration are significantly associated with the coronary lesions extent,degree and type,and the measurement of them may be helpful for diagnosing coronary plaque destabilization and the severity of coronary heart disease.