Value Of Serum Lectin-like Oxidize Low-density Lipoprotein Receptor-1in Prediction Of Acute Coronary Syndrome

Objective:To assess the value of serum lectin-like oxidized low-density lipoprotein receptor-1(LOX-1) in early prediction and prognosis evaluation of acute coronary syndrome(ACS).Methods:One hundred and sixty-four hospitalized patients were enrolled in the researsh,excluding of hepatic and renal insufficiency, severe heart failure, a history of trauma or surgery within the previous month, tumor, infectious disease,pregnancy, rheumatoid disease, after operation of coronary artery bypass graft, and thyroid diseases. Enzyme-linked immunosorbent assay wan used to detect the level of serum LOX-1in164patients who underwent coronary angiography,60normal control subjects,53with unstable angina(UA),51with acute myocardial infarction(AMI).63patients with proximal/mid segment of the coronary lesions and37patients with distal segments of the coronary lesions were included in this study.All the selected patients were detected myocardial enzymes, cTnI levels and fasting Triglyceride, total cholesterol, low density lipoprotein, very low density lipoprotein, high density lipoprotein, urea nitrogen, creatinine, uric acid. Admissions was routine tested by non-invasive hemodynamics monitor and automatic arteriosclerosis detector, for acceleration index, velocity index, pulse wave velocity, ankle brachial index. We observed ACS patients three months, and then detect the level of serum LOX-1again,。We compared the serum LOX-1level, other serum biochemical indicators, non-invasive hemodynamic parameters and automatic arteriosclerosis detector parameters among groups;The analysis of correlation relationship between LOX-1and ACI, PWV, ABI, coronary lesion segments were included in this study. We explored the LOX-1’s diagnostic value for ACS, UAP, and AMI patients. To assess the value of LOX-1in prognosis evaluation through the level changes of serum lox-1.Resules:1. ACS group’s LOX-1level was obviously higher than NC group (129.86±45.50pg/ml vs58.30±17.19pg/ml,P<0.01); The serum LOX-1level of AMI group was significantly higer than UAP group (141.87±48.15pg/ml vs118.29±39.92pg/ml,P<0.01)2. After3months follow-up, the serum LOX-1level of ACS patients (65.47±22.20pg/ml) was significantly lower than the acute phase of admission(129.86±45.50pg/ml)(P<0.01). The acute phase of AMI group’s serum LOX-1level(141.87±48.17pg/ml) was evidently higer than the period of stable plaque after three months (66.26±23.34pg/ml)(P<0.01), the previous LOX-1level of UAP group (118.29±39.92pg/ml) was higer than the later LOX-1level (64.72±21.24pg/ml)(P<0.01)3. Between the two different conronay lesion segments groups, the LOX-1level of proximal/mid segment of the coronary lesions group (135.25±43.83pg/ml) was higher than distal segment of coronary lesions group (114.82±34.01pg/ml)(P<0.05);4. ACS group’s ABI、ACI、VI were lower than NC group, PWV was larger than NC group; ACS group’s CK、CK-MB and cTnI were all higer than NC group。 AMI group’s ABI、ACI、VI were all lower than UAP group, PWV was larger than UAP group. Proximal/mid segment of the coronary lesions group’s PWV was higher than distal segment of coronary lesions group. AMI group’s CK、CK-MB and cTnI were all higer than UAP group.5. Negative correlation was found between LOX-1level and ABI (r=-0.205, p=0.008)、ACI (r=-0.295, p=0.002、VI (r=-0.288, p=0.004).And it is positive correlation between LOX-1level and PWV (r=0.462, p=0.000)6. The AUCROC of LOX-1for ACS patients was96.2%, it was higer than CK、CK-MB and cTnI, while for UAP patients, the AUCROC was merely34.8%, but still higer than CK、CK-MB and cTnI, for AMI patients the AUCROC was65.2%, was clearly lower than CK、CK-MB and cTnI, for Proximal/mid segment of the coronary lesions group,the AUCROC was63.7%, for distal segment of coronary lesions group AUCROC was only36.3%.Conlcusions:1. ACS group’s serum LOX-1level was significantly higher than NC group, AMI patients LOX-1level was clearly higher than UAP group, this indicated that LOX-1might be correlated with the formation of atherosclerotic and instable plaques, LOX-1might become a new biomaker.2. LOX-1level was correlated with the coronary lesion segments, coronary atherosclerotic plaques preferentially at proximal/mid segment of the coronary, proximal/mid segment of the coronary lesions group’s serum LOX-1level was significantly higher than distal segment of the coronary lesions group.3. After3months follow-up, consider the coronary atherosclerotic lesions is becoming stable according to the stable clinical condition, and the serum LOX-1level decline to the basic line,this indicated that LOX-1might be a new maker of prognosis and risk evaluation.4. Negative correlation was found between LOX-1level and ABI、ACI、VI. And it is positive correlation between LOX-1level and PWV.5. The AUCROC indicated that LOX-1’s diagnostic value for ACS patients was very good, but limited for AMI patients.