The Short-term Predictive Value Of Lp-PLA2 And Hs-CRP In Unstable Angina Pectoris Patients With Mildly Coronary Stenosis

Aim:To detect the peripheral blood levels of lipoprotein-associated phospholipase A2(Lp-PLA2)and hypersensitive C-reactive protein(hs-CRP) in mildly coronary stenosis patiens, 6 months clinical follow-up was performed for adverse endpoints.To study whether these Inflammatory markers could be predictors of mildly coronary stenosis unstable angina pectoris(UA) patients in short-term prognosis.Methods: According to patients' history symptoms/Inflammatory/ ECG and coronary arterigraphy,totally 89 patients were enrolled. Another 28 healthy volunteers were enrolled as control group. Lp-PLA2 and hs-CRP levels were tested in all entrants. 89 patients were followed up during 6 months. Primary endpoints were Cardiovascular Composite Endpoint Event, defined as cardiac death/ revascularization/ Myocardial infarction/ Heart failure. Divided by 90 days and 180 days, all patients were divided into the event group and the non event group. The Lp-PLA2 and hs-CRP levels in the two periods were compared by using the SPSS19.0 statistical software package.Results: The level of plasma Lp-PLA2 and hs-CRP were significantly higher in the observational group compared with that in control(219.45±39.76 ng/ml vs 135.64±26.35 ng/ml;4.29±1.23 mg/L vs 3.21±0.54 mg/L); The 90-day and 180-day Cardiovascular Composite Endpoint Event rates were 10% and 24%, respectively. TIMI score, smoking, Lp-PLA2, hs-CRP, LDL-C and total cholesterol concentration on mild-moderate stenosis UA patients are all releced to endpoint events. The area under the ROC curve of hs-CRP(area under the ROC curve= 0.879) for the prediction of endpoint events was higher than that of Lp-PLA2(area under the ROC curve=0.853) at the 90-day timepoint, but lower at the 180-day time point. COX regression analysis showed that Lp-PLA2 was an independent predictor of 90 days and 180 days end events, whereas hs-CRP was only of 90 days. Correlation analysis showed that TIMI score(r=0.331), hs-CRP(r=0.223), LDL-C(r=0.375) and total cholesterol concentration(r=0.346) were positively correlated with Lp-PLA2. TIMI score and hs-CRP were correlated(r=0.356).Kaplan-Meier survival analysis revealed that patients with an LP-PLA2 level > 244.385ng/ml and hs-CRP > 4.385mg/L were at highest risk for a endpoint event.Conclusions: 1. Lp-PLA2 and hs-CRP may be independent predictors of 90-day cardiovascular events in patients hospitalized with mildly oronary stenosis UA patiens. The specificity of Lp-PLA2 is higher.2. In predicting coronary patients with mild to moderate stenosis UA 180-day risk of cardiovascular events, Lp-PLA2 has a certain significance.3.Combined Lp-PLA2 and hs-CRP can improve the short-term predictive value in UA patiens with mildly coronary stenosis.