Relationship Among Small Dense Low Density Lipoprotein,Free Fatty Acids And Severity Of Coronary Artery In Patients With Acute Coronary Syndrome

Objective:To investigate the characteristics of small dense low density lipoprotein(sdLDL)and free fatty acid(FFA)in patients' plasma with acute coronary syndrome(ACS),and to evaluate the correlation between sdLDL,FFA and severity of coronary artery.Methods:We select 282 patients who suspected to have acute coronary syndrome(ACS)and underwent coronary angiography in The First Affiliated Hospital of Bengbu Medical College from Dec,2016 to Aug,2017,and clinical data were detailed collected.According to the results of coronary angiography and laboratory examinations,282 patients with suspected CHD were divided into four groups:92 in acute myocardial infarction(AMI),110 in unstable angina pectoris(UAP),30 in coronary sclerosis,50 in normal coronary.In addition,101 healthy subjects were selected as healthy control group.The degree of coronary was evaluated by Gensini score,then divided them 81 into ? 20 group,71 in 21?50 group and 80 in>50 group.The levels of plasma sdLDL,FFA,TC,TG,HDL,LDL,ApoAl and ApoB were measured in each groups.ANOVA was used to judge the difference of each correlation indexes.Bivariate Logistic stepwise regression analysis was employed to explore risk factors to the morbidity of ACS.The ability of related indexes diagnosis ACS were evaluated by ROC curve.Using Spearman correlation analysis to determine the correlation between the measured indexes and the Gensini score.Results:(1)The male rate in group AMI was significantly higher than that in the other four groups(P<0.05).The rate of male and hypertension in UAP group was higher than that in normal coronary artery group(P<0.05),and the incidence of diabetes in group AMI and UAP was significantly higher than that in normal coronary artery group(P<0.05).(2)The levels of FFA in the normal coronary group,the coronary sclerosis group,the UAP group and the AMI group were increased in turn,and the difference was significant compared with the control group(P<0.05).The levels of sdLDL,sdLDL/LDL ratio,TC,TG,LDL and ApoB in patients with ACS were significantly higher than control group(P<0.05),there was no significant difference between AMI group and UAP group(P>0.05).The levels of HDL and ApoAl in the four groups were significantly lower than the control group(P<0.05),and there was no significant difference between the groups(P>0.05).(3)The levels of FFA,TC,LDL and ApoB had a positive correlation with the Gensini score(P<0.05),and was no correlation between levels of sdLDL and Gensini score in patients with ACS(P>0.05).(4)The levels of FFA in ACS patients increased with the increase of Gensini score(P<0.05).The levels of FFA in AMI group and UAP group increased with the increase of Gensini score,but the difference was not statistically significant(P>0.05).(5)Sex,diabetes,ApoB and FFA were independent risk factors for ACS(P<0.05).(6)Combined detection of sdLDL and FFA has a certain ACS diagnostic ability(the area under the ROC curve was 0.741,sensitivity 59.9%,specificity 72%).Conclusions:These results suggested sdLDL and FFA are closely related to the occurrence of ACS.FFA may be a potential indicator to judge the severity of coronary artery disease.