Correlational Research Among Cute Coronary Syndrome, Fibrinogen And Blood Lipid

Objective: We pay more attention on the type and the degree of coronary lesions of cute coronary syndrome here. So we investigate its correlation with plasma fibrinogen(FIB) and blood lipid levels. According to the observation of value change on plasma fibrinogen (FIB) and apolipoprotein A1, we can find critical value of the occurrence of acute coronary syndrome (ACS) to help us with the clinical treatment.Methods: Choose 106 cases (male 32 cases, female 22 cases, age 43 ~ 85 years old) from September 2009 to February 2011,who were the first time in our hospital because of chest pain. And thus they were diagnosed acute coronary syndrome (ACS) through coronary angiography, According to the clinical manifestations, myocardial enzymology, ECG changes, they were further divided into two groups: acute myocardial infarction (AMI) group 54 cases (male 32 cases, female 22 cases) and the unstable angina pectoris (UAP) group 52 cases ( the male 31 cases, female 21 cases). Based on coronary artery lesions count, they were divided into single group 32 cases, double branch lesions group 33 cases and three branch lesions group 41 cases. The coronary artery lesions count is the main coronary artery with narrow diameter more than 50%. If a branch lesion among the left anterior descending branch (LAD), left circumflex (LCX) , right coronary artery (RCA) and big branches of above is narrow ,it will be a lesion group, 2 branch lesions are narrow ,it will be double lesions group, 3 branch lesions are narrow , it will be three lesions group . For left main coronary artery (LCM) lesions, no matter whether LCX or LAD has pathological changes or not, it will be double lesions group. If it also judged along with RCA lesions,it will be 3 branch lesions group. During the corresponding period in hospital,52 cases (male 30,female 22, age 46- 85 years,average 61.67±8.39 years old) were chosen as control group. Their coronary angiography is negative without other organic heart diseases. All cases didn't take thrombolysis drug, anticoagulants and lipid medicine before four weeks prior to admission. Fibrinogen were measured in emergency .The next morning after admission , the venous blood was collected to determine blood lipid with12-hour fasting 12h.Comparing the difference of each group, We analysis their correlation with acute coronary syndrome (ACS) type and the degree of coronary lesions and observe numerical changes of plasma fibrinogen (FIB) and apolipoprotein A1So that we can find critical value of the occurrence of acute coronary syndrome (ACS) to help us with the clinical treatment.Results: 1. Compared with control group, HDL-C (high-density lipoprotein cholesterol) were significantly reduced in AMI group and UAP group (P < 0.05). ApoA1 (apolipoprotein A1) group were significantly lower in AMI group and UAP group (P < 0.01). FIB was obviously higher in AMI group than in UAP group and control group (P < 0.01),It had no significant difference between UAP group and control group (P > 0.05).2. Through the observation and analysis to ApoA1 and FIB numerical, We find when ApoA1 is less than 1.3 mmol/l, it is possible to occur the UAP and when less than 1.22 mmol/l, The chance of occurring acute myocardial infarction's chance will be increased. When FIB is more than 2.6 g/l, it is possible to occur the ACS (unstable angina pectoris and acute myocardial infarction).3. It is positively correlated between the degree of coronary lesions and FIB level(R for 0.233, p value.003). It is negatively correlated between the degree of coronary lesions and HDL, ApoA1 level( R for-0.246,-3.73,p value for 0.002, 0.000) .linear stepwise regression analysis results show that ApoA1 and FIB have much more influence on the degree of coronary lesions.Conclusion: HDL, ApoA1 FIB and the occurrence are closely related with the development of acute coronary syndrome and the degree of coronary lesions. ApoA1 and FIB have much more influence on the degree of coronary lesions. It reminding us that as we intervene HDL-C, LDL - C, TC to achieve control goals, we should rise. ApoA1 level, to make it more than 1.3 mmol/l and reduce FIB level to make it lower than 2.6 g/l. Thus it maybe has great clinical significance to prevent the occurrence and development of acute coronary syndrome.