The Level Of Serum Caveolin-1 In Patient With ST-segment Elevated Myocardial Infarction And Its Clinical Value

Objective:To compare the difference of serum caveolin-1(CAV-1)levels between normal and ST-segment elevation myocardial infarction(STEMI)patients and its clinical value in addition to explore the correlation between the level of CAV-1and other clinical risk factors for coronary heart disease.Methods:Twenty-five STEMI patients and twenty stable angina pectoris from July 2017 to December 2017 in Department of Cardiology,The first affiliated Hospital of Dalian Medical University were selected in this study,STEMI patients select have undergone coronary angiography and necessary percutaneous coronary intervention(PCI).,Patients with stable angina with at least one vascular between fifty and ninety percent narrow and no PCI.Twenty-five patients undergoing coronary angiography and excluding coronary artery disease were enrolled in the control group.All selected patients met the inclusion criteria,did not meet exclusion criteria and all signed informed consent.Record all patient baseline clinical data:including gender,age,history of type 2 d iabetes mellitus,history of hypertension,and history of smoking.Extraction of peripheral venous blood on the day of admission for determination of high sensitivity cardiac troponin I(hs-cTnI),blood routine,hemoglobin A1C(HBA1C),total cholesterol(TC),triglyceride(TG),low density lipoprotein(low densitylipoprotein-cholesterol,LDL-C),high density lipoprotein-cholesterol(HDL-C),creatinine(CRE),high sensitivity reactiviie protein(hs-CRP)and brain natriuretic peptide(BNP),calculate glomerular filtration rate by creatinine and age,Left ventricular ejection fraction is measured by cardiac ultrasound,SYNTAX scores obtained from online calculation tools based on coronary angiography results.Detection of serum CAV-1 concentration by ELISA.Using Graph Pad Prime 5 and SPSS 21 software to perform statistical analysis and chartingResults:The comparison of clinical baseline data among the three groups of patients show that there was no significant difference in gender(male percentage),age,history of hypertension,history of diabetes,smoking history,TG,HDL-C,CRE,eGFR,Hb A1C,LVEF,SYN TAX scores(P>0.05).However,serum TC and LDL-C levels in STEMI and SAP groups were significantly higher than those in controls(TC:STEMI grpup 4.92±0.78mmol/L VS SAP group 4.95±1.14mmol/L VS CON group 4.31±1.01mmol/L,P<0.05)and(LDL-C:STEMI group 3.08±0.74mmol/L VS SAP group 2.95±0.84mmol/L VS CON group 2.45±0.7mmol/L,P<0.05);at the same time,the hs-c TnI,hs-CRP,WBC,and BNP in the STEMI group were significantly higherthantheSAPgroupandthecontrolgroup.(hs-cTnI:38.980(3.942,134.275)ug/L VS SAP group 0.006(0.006,0.012)ug/L VS CONgroup0.006(0.006,0.006)ug/L,P<0.001;hs-CRP:STEMI group7.19(4.71,14.75)mg/L VS SAP group 1.22(0.81,5.33)mg/L VS CON group1.57(0.63,3.69)mg/L,P<0.001;WBC:STEMI group 10.21±3.83*10e~9/L VS SAP group 6.63±7.94*10e~9/L VS CON group 6.33±1.74*10e~9/L,P<0.0001;BNP:STEMI group 226.12±244.72pg/ml VS SAP组93.71±96.84pg/ml VS CON group32.67±27.57pg/ml,P<0.001).The levels of serum CAV-1 in three groups of patients show that the STEMI group was significantly higher than the SAP group(557.32±149.65pg/ml VS 420.35±110.94pg/ml,P<0.01),at the same time,the STEMI group was also higher than the control group(557.32±149.65pg/ml VS 247.36±79.54pg/mL,P<0.001);In addition,compare with the control group,the SAP group was higher(420.35±110.94pg/ml VS 247.36±79.54pg/mL,P<0.001).The results of correlation between serum CAV-1 levels with lipids,hs-CRP and SYNTAX scores showed:Serum CVA1 levels in STEMI patients was linearly related to TC(r=0.587,P=0.002),TG(r=0.543,P=0.005),and LDL-C(r=0.619,P=0.001).But no linear relationship with HDL-C(P=0.313);There was a linear correlation between CAV1 and TC(r=0.541,P=0.013)and LDL-C(r=0.530,P=0.016)in SAP group;In the control group,no linear correlation was found between CAV1 and lipid;Serum CAV1 levels in patients with STEMI were linearly correlated with hs-CRP and hs-cTnI(r=0.588,P=0.002;r=0.516,P=0.038).However,there was no linear correlation in SAP patients and controls.There was no linear relationship between serum CAV1 levels and SYN TAX both in STEMI and SAP patients.Logistic multi-factor stepwise regression analysis show:hs-CRP(P=0.020,OR=2.291,95%CI=[1.138,4.611])and LDL-C(P=0.041,OR=1356.548,95%CI=[1.342,1371000])is an independent risk factor for STEMI,but other coronary heart disease risk factors including CAV-1 were not independent STEMI risk factors.Combining the STEMI group with the SAP group into the coronary heart disease group only found that hs-CRP was an independent risk factor for coronary heart disease(P=0.033,OR=2.721,95%CI=[1.084,6.832]).Conclusions:Serum levels of CAV-1 were significantly elevated in STEMI patients.And there was a linear positive correlation between CAV-1 with blood lipids,high sensitivity cardiac troponin I and high-sensitivity C-reactive protein levels.