Correlation Between The Level Of Serum Liver Enzyme And The Severity Of Coronary Artery Lesions And Prognosis In Patients With Coronary Heart Disease

Objective In recent years,with the rapid development of social economy,improvement of material life and the consolidation of the aging of population,the incidence of coronary heart disease is increasing and it has become an important disease that threatens human life and health.In recent years,studies have found that the level of serum liver enzyme is associated with the occurrence and development of coronary heart disease.The specific mechanism of hepatic enzymological changes in the development of coronary heart disease is not yet clear,and the studys between the level of serum liver enzyme and the severity of coronary lesions and prognosis in patients with cornory heart disease are relatively fewer.The purpose of this study is to research the relationship between the level of serum alanine aminotransferse(ALT)??-glutamyltransferase(GGT)?bilirubin(BIL)and the severity of coronary lesions and prognosis.The popuse of this study is to provide important predictive value for early diagnosis and prognosis of patients with coronary heart disease.Methods 240 patients were selected including 181 males and 59 females,who were diagnosed coronary heart disease at the Department of Cardiology,the Second Affiliated Hospital of Zhengzhou University from January 2015 to January2017.After coronary angiography,the patients were divided into three groups according to the SYNTAX score:mild group(SYNTAX score:0-22),moderate group(SYNTAX score:23-32),and severe group(SYNTAX score:higher than 33points).The results of coronary angiography of the control groups with 60 cases showed no clear stenotic lesions or the lesions <50%.The clinical data,biochemical data and coronary artery angiography were recorded.All patients with coronary artery disease were followed up for a period of one year after discharge and the occurrence of major adverse cardiac events(MACE)was recorded.We use the Spearman method to analyze the correlation between the level of ALT ? GGT ? BIL and the SYNTAX score.Logistic regression analysis was used to analyze the relationship between the severity of coronary artery lesions and various risk factors,and then to find out the risk factors of coronary heart disease.Results1.The differences in sex,ALT,TBIL,DBIL,GGT,TC,HDL-C,LDL-C,GLU between the control group and each subgroup of coronary lesions were statistically significant(p<0.05),but the other factors such as age,BMI,smoking,hypertension,diabetes,AST,IBIL,TG,ALP,BUN,Cr,UA were not significantly different(p>0.05).With the increase of the severity of coronary artery lesions,the level of ALT ?GGT were gradually increased,but the level of TBIL?DBIL were gradually decreased:and the differences were statistically significant(p>0.05).The level of IBIL was gradually decreased,but the difference was not statistically significant(p>0.05).2.Spearman correlation analysis showed that serum ALT was positively correlated with GLU,TC,TG and LDL-C;serum GGT was positively correlated with TC,TG and LDL-C;serum ALT,GGT and HDL-C were negatively correlated.Serum TBIL and DBIL were negatively correlated with TC,TG and LDL-C;serum IBIL was negatively correlated with TG;serum TBIL,DBIL and IBIL were positively correlated with HDL-C.3.Spearman correlation analysis showed that serum ALT,GGT and SYNTAX score were positively correlated(p<0.01);serum TBIL and DBIL were negatively correlated with SYNTAX score(p<0.01);serum IBIL had no correlation with SYNTAX score(p>0.05).4.The SYNTAX score(mild group,moderate group and severe group)was used as the dependent variable,the sex,ALT,AST,TBIL,IBIL,GGT,TC,HDL-C,LDL-C and GLU,which were significant by one-way ANOVA and nonparametric test,were used for independent variable,and we used an ordinal ploytomous Logistic regression analysis to analyze.The results showed that sex(male),the elevated level of serum ALT,GGT,TC,LDL-C,GLU and the low level of serum TBIL,HDL-C were independent risk factors for the severity of coronary artery lesions.5.The 240 patients with coronary heart disease who were enrolled in the study were followed up for one year after discharge.There were 23 cases of MACE,including 11 cases of recurrent angina pectoris,5 cases of non-fatal cardiac infarction,3 cases of heart failure,2 cases of percutaneous coronary intervention and 2 cases of death.The level of serum ALT,GGTof the MACE group was higher than non-MACE group;the level of serum TBIL was lower than non-MACE group,and the differences were statistically significant(p<0.05).There was no significant difference in the level of serum DBIL and IBIL between MACE group and non-MACE group(p>0.05).It indicated that the elevated level of serum ALT,GGT and the low level of serum TBIL had a predictive value for the risk of MACE.Conclusions1.The level of serum ALT,GGT is positively correlated with the severity of coronary artery lesions,and the level of serum TBIL,DBIL is negatively correlated with the severity of coronary artery lesions.2.The elevated level of serum ALT,GGT and the low level of serum BIL are closely related to the occurrence and development of coronary heart disease.The elevated serum ALT,GGT and low serum TBIL are independent risk factors for coronary heart disease.3.The elevated level of serum ALT,GGT and the low level of serum TBIL have important predictive value for the poor prognosis of patients with coronary heart disease.