The Analysis For The Relationship Of Heat Shock Protein 60 And Coronary Atherosclerotic Heart Disease

Background and ObjectRecent researches show a new point that coronary heart disease is a kind of disease related with immunity and inflammation. The heat shock proteins (HSPs) are high-conserved family of protein which possess indispensable physiological functions. There's a view that heat shock protein 60 family is one of the most important auto-antigens which may elicit an autoimmune response during early atherogenesis. The probable mechanisms that HSP60 cause atherogenesis might be:(1)Microbe infections activate auto-immune system through cross-react immunoreactions and molecular mimicry. (2) Cause the release of inflammatory cell factors. (3)The injury of vascular endothelium caused by immune complexes consisting of HSP60 and anti-Hsp60 antibodies. (4) The immunoreactions to soluble HSPs. After acute coronary events, the partial hemodynamic has been changed, many kinds of cell factors and coagulation factors are released which promote the release of HSP. The mensuration of HSP60 can not only forecast the dangerous of suffer from CHD and myocardial infarction, but also show its value in the diagnosis of CHD and evaluate the dangerous of the disease. A couple of researches show that the level of HSP-60 in AMI patients is obviously higher than it in UA and SA patients, but there's rare discuss about it's value using in clinical for the diagnosis and assessment of CHD. This research deliver the patients admitted to hospital because of chest pain into four groups according to their clinical features, coronary arteriography results and the severity of vessel straitness. Comparing different levels of HSP-60 among groups, and analyses it's pertinency with NT-proBNP and syntax score, etc, to discuss the relationship between HSP-60 and CHD, and also explore the value of HSP-60 using in clinical.Materials and methodData includes 80 patients (60 male,20 female, mean age 63.16±8.80) admitted to the department of cardiology of Zhongshan Hospital because of chest pain from December 2009 to March 2010. After they admitted in, patients are delivered in four groups:N, SA, UA and AMI, according to the clinical feature and Coronary Arteriography, Blood samples were collected at the day after patients admitted to hospital and the concentration of HSP-60 were tested by ELISA. Use a software of SPSS 17.0 for statistics analysis, measurement data was described by mean±standard deviation (x±s),categorical data was described by percentage(%).Use logistic regression analysis to analyze multiple factors, and calculate odd ratio and 95% confidence interval, it is considered to be statistic meaningful while P<0.05.Comparing different levels of HSP60 in different group to discuss the relationship between HSP-60 and CHD, and also explore the value of HSP-60 using in clinical.ResultsComparing the general data and blood chemical data, no difference was examined in age, HBP, diabetes, FBG, two hours-BG after meal, HbAlc, HDL-C, triglyceride, creatinine among four groups. The percentage of male patients in normal group is lower than the other three (P<0.01).The concentration of total cholesterol and LDL-C is higher than the other three groups (P<0.05,P<0.01).The level of HSP-60 is higher in AMI group than it in normal group (P<0.001).SA group (P<0.001),and UA group(P<0.001).It is also higher in UA group than in N and SA group(P=0.004, P=0.005).No statistic meaning for the difference of HSP-60 between N and SA group. The level of HSP-60 is higher in MV group than it in NV group (P<0.001).SV group (P<0.001),and DV group(P<0.001).It is also higher in DV group than in N group (P=0.009). No statistic meaning for the difference of HSP-60 between SV and DV group. No statistic meaning for the difference of HSP-60 among LAD, LCX, RCA groups. The level of HSP-60 is lower in low-syntax-score group than it in the other two groups (P<0.001,P<0.001).It is also lower in mid-syntax-score group than in high-syntax-score group (P=0.047). ROC curve shows a area of 0.756 under it. According to the ROC curve, the break up point of HSP-60 is 8.0ng/ml. The sensitive and specificity in forecasting CHD of this concentration is 55% and 90%. The analysis of HSP-60 and NT-proBNP shows a line correlation, R2=0.778.The analysis of HSP-60 and syntax score shows a spearman correlation, r=0.683,P<0.001, Further logistic regression analysis among HSP-60 and other probable risk factors to CHD shows that HSP-60 is an independent risk forecast factor.ConclusionHSP-60 level can reflect the unstable state of plague, may reflect the severity of vessel straitness. It can be used to guide the proper manner for patients to rebuild blood supply. It also can be used to diagnosis CHD in high-risk people. It may forecast the prognosis of acute coronary syndrome. Furthermore, it is an independent risk forecast factor for CHD.