Soluble Lox-1and Other Four Biomarkers In Diagnosis Of Acute Coronary Syndrome

Objective：Acute coronary syndrome (ACS) is a kind of Clinical syndrome，which dueto the unstable atheromatous plaque erosion, broken, and which will lead to plateletaggregation and thrombosis, and lead to a set of clinical acute myocardial ischemiaanoxic syndrome. The ACS is a common clinical cardiovascular emergency, it is alsoone of the common cause of sudden death in patients. So to make early diagnosis inpatients with ACS, and to take positive and effective measures can effectively reducepatient’s mortality and improve prognosis of patients. So that a class of biochemicalmarkers that can reflect the the early stages of ACS is accepting more and moreattention. sLox-1is a marker of this kind,which can reflect instability of atheroscleroticplaque. It is found that,the level of sLox-1begins to rise around90minutes after theonset of ACS,and drops within24hours.This article aims to use the Logistic regressionand the ROC curve to evaluate the value of soluble Lox-1, in the early ediagnosis ofACS（part I）．Using Logistic regression and ROC curve to evaluate the diagnosisvalue of sLox-1, troponin I, creatine kinase isoenzyme, myoglobin andhypersensitive c-reactive protein alone or Joint detection for ACS (part2).Methods：(part I): We have two groups:the ACS group68cases,male53cases,female15cases, mean age (63.0±14.1), the group which within3hours of bloodcollection(<=3h)included29cases.The3-6hours group included39cases; The ACSgroup40cases, male33cases, female7cases, mean age (61.9±15.7). All cases were excluded from acute or chronic kidney dysfunction, malignant tumor, thyroid disease,autoimmune diseases, infectious diseases and complications such as connective tissuedisease. Serum SLox-1, troponin I (cTnI), myoglobin (Myo) are tested. Using theLogistic regression model, draw the ROC curve, to obtain the value of sLox-1alone orjoint detection with cTnI and CK-MB in the early diagnosis of ACS.(Part Ⅱ)119patients with coronary heart disease which had been confirmed bycoronary angiography were included in this study, including acute coronary syndromegroup (78cases) and stable angina group (41cases). All cases are excluded from Acuterenal insufficiency, Acute hepatic insufficiency, malignant tumor,thyroid disease,autoimmune diseases, infectious diseases and complications such as connective tissuedisease. Another group included41cases without coronary heart disease, which hadalso been confirmed by coronary angiography. Concentrations of sLox-1, Myo, cTnI,CKMB and hs-CRP were measured, and the Logistic regression model and the ROCcurves were used to evaluate the diagnostic value for ACS.Results：(part I)The serum level of sLox-1、Myo and CK-MB in the within3hgroupand the3-6h group are higher than the control group, and the difference had statisticalsignificance (P <0.05). The area under the curve of the Within3h of onsetgroup is0.951, with sensitivity (82.8%), specificity (95.0%),which were higher than that of cTnIand Myo."cTnI+sLox1" The area under the curve of the diagnosis of ACS for theWithin3h of onset group and3-6h group is0.951and0.971, and the diagnosticperformance parameters is much better than "Myo+cTnI" joint detection.(Part Ⅱ) For sLox-1,the area under the ROC curve is0.934. The diagnosticrelevance of the five biochemical markers for ACS is sLox-1> Myo> cTnI> CKMB>hsCRP. The area under the ROC curve of the "sLox-1+cTnI+Myo" combination forACS is0.987. The diagnostic sensitivity and specificity is93.9%and96.2%,respectively, which is higher than any of the biomarkers alone and the combination of "Myo+cTnI+CKMB".Conclusion：SLox-1is used for the early diagnosis of ACS, with high specificity andsensitivity, and troponin I and myoglobin for joint detection can play agoodcomplementary role, when compared with single detection the diagnosis efficiencygreatly improved, and higher than "troponin I and myoglobin+CKMB" joint detection(part I).SLox-1has certain value for diagnosing ACS."sLox-1+cTnI+Myo"combination plays a better role in diagnosing ACS than sLox-1alone and the"Myo+cTnI+CKMB" combination(part Ⅱ).