| Background Cardiac syndrome X(CSX),known as “microvascular angina”,is defined as the symptoms caused by abnormalities of small coronary arteries 50-500?m in diameter.CSX is more common in perimenopausal women and is characterized by exercise-induced angina pectoris,the curative effects of nitroglycerin are poor.The pathogenesis of CSX is complex and inflammation may play an imp ortant role.Treadmill exercise testing(TET)can be the first choice to detect CSX,but it has many disadvantages.It was thought that the prognosis of CSX is well,but because of repeated attacks,CSX increases hospitalization rates,and has an adverse impact on patients' quality of life.Lipoprotein-associated phospholipase A2(Lp-PLA2)is a new,recently studied inflammatory biomarker and therapeutic target,its role in atherosclerosis disea ses(such as coronary heart disease(CHD)and stroke)is confirmed by many studies,however,the value of Lp-PLA2 in patients with CSX remains unclear.Creactive protein(CRP),including high-sensitive C-reactive protein(hs-CR P),is a widely used nonspecific indicator of inflammatory processes,the study of CRP lasted for over eighty years.Originally,it was used for auxiliary diagnosis of infectious diseases,however,the data in recent years showed that its value in cardiovascular and cerebrovascular diseases(such as CHD,atrial fibrill ation and stroke)also becomes the focus of attention.It was reported that the concentration of CRP is elevated in patients with CSX.Objective To observe the changes in the concentrations of Lp-PLA2 and hs-CRP in plasma in patients with CSX and to analyze and compare their clinical signific ances.Methods A total of 51 patients hospitalized for CSX were recruited as a case group and 51 patients without CSX were recruited as a control group in the First Affiliated Hospital of Zhengzhou University between April 1,2015 and Decem ber 1,2015.The plasma Lp-PLA2 was detected by immunochromatography of a doubleantibody sandwich and the plasma hs-CRP was detected by the emulsion meth od.Uric acid(UA),total cholesterol(TC),triglyceride(TG),high-density lipoprote in cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)in plasma and fasting plasma glucose(FPG)concentrations were also determined.All statistical analyses were performed using SPSS 17.0: continuous variables were presented as means±SD or medians(25th,75 th percentiles),and dicho tomous variables as percentages;differences in continuous variables between the two groups were assessed using unpairedt test or Wilcoxon rank sum test,and differences in dichotomous variables between the two groups were assessed using Chi-square test;correlations were assessed using Pearson or Spearman rank correlations;influence factors in CSX were identified using unconditional lo gistic regression analysis.Statistical significance was defined by P<0.05.Results1.The concentrations of Lp-PLA2,hs-CRP,TG in plasma and FPG were higher in the case group than those in the control group(202.80±65.67ng/ml versus 172.43±59.62ng/ml,P=0.016;0.71(0.37,1.85)mg/L versus 0.44(0.28,1.20)mg/L,P=0.033;1.32±0.61mmol/L versus 1.09±0.44mmol/L,P=0.037;4.73±0.56mmol/L versus 4.41±0.44mmol/L,P=0.002).2.The positive rate of plasma Lp-PLA2 was higher in the case group than that in the control group(66.6% versus 45.1%,P=0.028).3.The plasma Lp-PLA2 was positively correlated with plasma TC,and negatively correlated with plasma HDL-C(r=0.470,P=0.000;r=-0.452,P=0.000).4.The plasma Lp-PLA2 and FPG were associated with the risk of CSX(OR=1.009,95%CI: 1.002-1.017,P=0.011;OR=3.644,95%CI: 1.417-9.374,P=0.007).Conclusion The Lp-PLA2 may be a more valuable biomarker in comparison to the hs-CRP in plasma in CSX. |
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