The Correlation Of Serum High-sensitivity Cardiac Troponin T And The Syntax Score In Patients With Unstable Angina Pectoris

Background:Coronary heart disease(CHD)is the result of coronary artery plaque formation,vascular stenosis,blood flow limitation,myocardial organic or functional changes after myocardial ischemia,the pathogenesis is complex,with the deepening of biochemical inspection technology,the forewarning role of biomarkers was put high value by people gradually.The high-sensitivity troponin T(hs-c Tn T)closely related with the severity of acute coronary syndrome(ACS),and the use of the hs-c Tn T to early diagnosis and exclusion of ACS was advocated in foreign literatures.The hs-c Tn T was associated with the long-term prognosis of patients with CHD,whether in percutaneous coronary intervention or coronary artery bypass grafting.The hs-c Tn T was associated with acute coronary lesions.When the ischemia and necrosis occurs in the heart cell,the cell membrane permeability increased,the hs-c Tn T released into the bloodstream.Low content of hs-c Tn T may be due to the local rupture of coronary plaque,tiny thrombosis and local necrosis of myocardial cells.Studies have shown that the hs-c Tn T can not only as an effective indicator to assess patients,but also can be used as a prognostic indicator for a long time.Even in some of the ordinary population,low content of hs-c Tn T also had a closely related to the long-term survival rate of patients and cardiovascular events.But the research of hs-c Tn T was mainly concentrated in the early diagnosis,treatment and prognosis of ACS evaluation at present.In clinical work,the research in patients with unstable angina was lack,especially the relationship between hs-c Tn T and coronary artery lesion was unclear.Objectives:To investigate the correlation of serum high-sensitivity cardiac troponin T and the Syntax score in patients with unstable angina pectoris.Methods:One hundred and fifty-seven patients with unstable angina pectoris in our hospital were selected and the score of coronary angiography was evaluated from April 2015 to December 2015.The severity of coronary artery disease was evaluated by Syntax score.According to the results of Syntax score,the 157 patients were divided into two groups: Low score group 97 cases(?22 points),in which 62 cases were male,35 female,age 43~85,mean age(63.44�939);in high group(> 23 points)60 cases,in which 41 cases of male,female 19,age 45~79,mean age(65.11�8.28).The correlation between the content of hs-c Tn T and the Syntax score of coronary angiography were compared in the two groups.The informed consent of all of the subjects were signed,and the archives for patients were established.The background information were collected from the subjects,including age,gender,body mass index,hypertension disease,history of diabetes,smoking history,coronary heart disease family history,real fibrillation history,fasting blood glucose,blood pressure,heart rate,blood creatinine,total bilirubin,blood lipid,CRP,BNP and NYHA classification,left ventricular ejection fraction(LVEF)data.Venous blood was collected before coronary angiography,and the serum was kept at-80? for frozen preservation,Syntax score was performed on all patients with coronary angiography,the average content of hs-c Tn T in each group was calculated.All data were analyzed using statistical software SPSS 22.The variables which was continuous and fellow a normal distribution,were presented as mean values � SD.Independent t-test were used in comeparing between two groups.Classification variables to rate,group count data compared with chi square test.The associations between hs-c Tn T levels and coronary Syntax score was assessed using Spearman's correlation coefficient.Multivariate linear regression analysis and multivariate Logistic regression analysis were adopted to analyze the multiple factors,and p< 0.05 for the difference was statistically significant.Results:1)There were statistically significant differences in the level of BNP(4.503 � 91.56pg/m L vs 109.01� 179.79pg/m L,p < 0.05),left ventricular ejection fraction(LVEF)(64.91� 4.97% vs 61.97� 8.33%,p<0.05),bilirubin(12.79�4.97?mol/L vs 11.35� 3.43?mol/L,p = 0.05)and high-sensitivity troponin T(7.80� 7.55pg/m L vs 55.84� 90.11pg/ m L,p < 0.05)between the two groups;2)A significant Spearman correlation was found between hs-c Tn T levels and Syntax(r=0.321,p<0.001);3)Multiple stepwise regression analysis demonstrated that plasma hs-c Tn T was an independent predictor of angiographic extent of UA(?= 0.077,p<0.05),BNP(?=0.020,p<0.05)and bilirubin(?=0.481,p<0.05)were also independently associated with the SYNTAX score;4)Multiple logistic regression analysis: hs-c Tn T is independent predictor of Syntax score(OR=1.148,95% CI: 1.087~1.212,p<0.05).Conclusions:In patients with unstable angina pectoris,the content of hs-c Tn T was significantly higher than that of low score group,and the hs-c Tn T in serum and the Syntax score significantly associated with the degree of coronary artery lesions,i.e.the higher the hs-c Tn T patients,the more serious degree of pathological lesions in patients.There is a positive correlation between the content of BNP and the degree of coronary artery lesion,but the content of bilirubin is a negative correlation with the coronary lesions.The hs-c Tn T is a reliability index of responding the severity of coronary lesions,and can be used as an evaluating tool effectively.