Detection And Clinical Significance Of Soluble CD146 In Plasma Of Patients With Different Types Of Coronary Heart Disease

BackgroundMany existing studies have confirmed that vulnerable plaque of coronary artery is the main cause of cardiovascular acute events.However,at present,the clinical assessment of vulnerable plaque is mainly based on interventional or noninvasive imaging,but most imaging techniques can only evaluate some characteristics of vulnerable plaque,and can not predict the progress of the disease.And imaging examination can not be the best means of risk monitoring for patients with coronary heart disease from the aspects of economy,operability and examination time.In recent years,it has been found that soluble CD146(soluble cluster of differentation 146,sCD146)can promote the production of small blood vessels in plaque and participate in inflammatory response,can promote the formation and development of cervical arterial plaque,and has the effect of promoting the instability of plaque.However,the relationship between scd146 and coronary plaque in patients with coronary heart disease is rarely reported.ObjectiveBy observing the difference of plasma soluble CD146 levels in patients with different types of coronary heart disease,to explore the predictive value of coronary heart disease.MethodsFrom November 2018 to February 2019,inpatients were collected from the second ward of cardiovascular department,the First Affiliated Hospital of Xinxiang MedicalCollege,According to the clinical manifestations and the results of coronary angiography,the patients were divided into acute myocardial infarction group,unstable angina group and stable angina group.Those without obvious abnormality in coronary angiography were normal control group.Use ELISA to detect the level of sCD146.The Gensini score was calculated according to the results of coronary angiography,and the clinical data of each group were statistically classified.The counting data is represented by the number of cases and percentage,which enables the card test.The measurement data conform to the normal distribution,which is expressed in~c±s.The difference analysis is adopted for the comparison of the difference.If the difference does not conform to the normal distribution,the parameter rank sum test is adopted for the analysis.The risk factors of acute coronary syndrome were analyzed by logistic regression.Correlation analysis not in accordance with normal distribution uses Schumann analysis.The ROC curve of predicting different types of coronary heart disease was statistically significant(P<0.05).ResultsWBC(OR=2.512,95%CI:1.21-5.214)?CK-MB(OR=2.119,95%CI:1.059-4.24)?ALT(OR=1.963,95%CI:1.222-3.153)?AST(OR=2.219,95%CI:1.095-4.497)?Cr(OR=1.202,95%CI:1.016-1.421)?LVDd(OR=1.802,95%CI:1.221-3.847)?LVEF(OR=2.203,95%CI:1.262-3.847)and the level of sCD146(OR=2.118,95%CI:1.114-4.027)were the risk factors of ACS(P<0.05).The level of scd146 in coronary heart disease group was significantly different from that in normal control group(P<0.05),and Spearman correlation analysis showed that there was a positive correlation between the level of scd146and Gensini score in the coronary heart disease group(?=0.778,P<0.001).By establishing ROC curve,it can be seen that plasma scd146 has statistical significance in predicting the occurrence of three types of coronary heart disease(P<0.05).When the level of plasma scd146 was 187.4ng/ml,the sensitivity and specificity of predicting acute myocardial infarction were the best,87.02%(95%CI:78.5-94.4)and 88.2(%95%CI:79.5-96.7)respectively,and the yoden index was 0.752;when the level of plasma scd146 was170.3ng/ml,the sensitivity and specificity of predicting unstable angina were the best,96.01%(95%CI:83.2-99.6)and 76.48%(95%CI:50.1-93.5)respectively,and the yoden index was0.725.When the level of scd146 was 147.43ng/ml,the sensitivity and specificity of scd146were 62.5%(95%CI:35.4-84.8)and 76.47%(95%CI:50.1-93.2)respectively.and the yoden index was 0.390.ConclusionsThe level of scd146 may reflect the development of coronary artery disease and provide a new way to predict the condition of coronary heart disease.