Study Of The Relevance And Clinical Diagnostic Value Of Coronary Artery Calcification Related Markers And Calcific Integral

Objective: Investigated the relevance and clinical diagnostic value of coronary artery calcification cardiac related markers and calcific integral. Methods: The principle of evidence-based medicine would be used in estimated the literatures which be brought into and markers in the literatures. Used dual source CT to examine and calculate patients’ calcification integral. Detected the serum markers level of normal people and patients with different calcification integral coronary heart disease by ELISA method, and statistical analyze the result. Selected significant difference markers to draw the ROC curve which used the application of statistical software. Through the area under ROC curve(AUC) to evaluate the effect of the diagnosis in joint detection of cardiac markers. The coronary artery calcification integral parameter model was established and that was evaluated. Results: Used the method of evidence-based medicine on 691 articles and 22 markers which was evaluated by statistical analysis. Finally, 52 articles were included. There were 9 biomarkers related with coronary artery calcification(IL-10 、 IL-18 、 PAPP-A 、HMGB1、1,25(OH)2D3、APN、HIF-1a、MGP、OPN). After the serum levels of disease group and control group were detected. the serum levels of 1,25(OH)2D3、HIF-1a、IL-18、MGP and OPN markers in two groups had statistical difference(p<0.05). The comparison of serum levels of markers among different scoring groups: The serum levels of 1,25(OH)2D3、IL-18、HIF-1a、MGP and OPN markers in two groups had statistical difference(p<0.05). The result of contrast between mild calcification group and control group was showed that the serum levels of HIF-1a and OPN markers in two groups had statistical difference(p<0.05). The result of contrast between moderate calcification group and control group was showed that the serum levels of HIF-1a 、IL-18、MGP and OPN markers in two groups had statistical difference(p<0.05). The result of contrast between serious calcification group and control group was showed that the serum levels of 1,25(OH)2D3、HIF-1a、IL-18 and MGP markers in two groups had statistical difference(p<0.05). Correlation analyzed of calcification and various markers serum level display as follows: The result of contrast between Calcific integral with 1,25(OH)2D3、HIF-1a、IL-18、MGP and OPN had statistical difference(p<0.05). There was positive correlation between calcific integral with HIF-1a、IL-18、MGP and OPN, there was negative correlation between calcific integral with 1,25(OH)2D3. Associated with two, three, four and five markers would have significant diagnostic value. Associated with HIF-1a 、 MGP and 1,25(OH)2D3 would have significant diagnostic value, The areas under the ROC curve were 0.845. The calcification parameters model was established by logistic regression analysis(Ln P=-3.99+0.013*1,25(OH)2D3+0.096*HIF-1a+0.005*MGP). The computational error, between the calcific integral and actual calcific integral, of this model was 0.45%~14.7%. It was fitful and reliable. Conclusion: 1.The result of contrast between different calcification group and control group was showed that the serum levels of 1,25(OH)2D3、HIF-1a、 IL-18、MGP and OPN had statistical difference. There was relativity between calcific integral with 1,25(OH)2D3、HIF-1a、IL-18、MGP and OPN. These biomarkers could be used as a diagnostic index for CHD diagnosis. 2. Associated with multiple markers would have significant diagnostic value. Associated with HIF-1a、MGP and 1,25(OH)2D3 would have significant diagnostic value. 3. The parametric model, which can be a reference tool to assess calcification score can be a supplement and reference of the dual source CT coronary angiography and save medical cost and avoid have a check.