| Objective: To study the relationship between interleukin-33(IL-33),Soluble suppression of tumorigenicity 2(s ST2)and lysophosphatidic acid(LPA)in patients with Acute coronary syndrome(ACS)expression level and the severity of coronary artery lesions(Gensini score).To investigate the relationship between the expression level of peripheral IL-33/s ST2 and LPA and coronary artery lesions in patients with ACS,and their diagnostic value in predicting the occurrence of ACS.Methods: Patients with coronary heart disease who were hospitalized in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Hainan Medical College from March 1,2021 to April 30,2022 and obtained informed consent were selected.Coronary angiography(CAG)was performed in all patients.According to the inclusion and exclusion criteria,the subjects were divided into ACS group and SA group.Non-cardiac chest pain patients with normal CAG results in hospital during the same period were selected as the control group.Gensini score was used to assess the severity of coronary artery lesions in ACS patients.The clinical data,laboratory examinations,routine electrocardiogram and echocardiography of the patients were collected.And 8ml of peripheral blood was collected,which 5ml of separated serum was used to detect IL-33/s ST2 and 3ml of separated plasma was used to detect LPA by enzyme-linked immunosorbent assay(ELISA).SPSS 26.0 was used for statistical analysis,categorical data was tested by χ2,measurement data that met normal distribution were expressed as mean ± standard deviation((?)±s),and Wilcoxon rank sum test was used when data did not conform to normal distribution or uneven variance and test.Spearman was used to analyze the correlation.Binary Logistic regression was used to analyze the independent risk factors of ACS,and the area under the ROC curve(AUC)was calculated to evaluate the value of predicting the occurrence of ACS.P<0.05 indicated that the difference was statistically significant.Results:A total of 213 patients were included,including 122 patients in the ACS group,44 patients in the SA group,and 47 patients in the control group.In the ACS subgroup,there were 36 patients were STEMI,41 patients were N-STEMI patients and 45 patients in the UA group.According to the Gensini score,patients in the ACS group were divided into a high-risk group with 88 patients and a low-risk group with 34 patients.1.The expression of Serum IL-33 was 57.08±27.77pg/ml,04.87±65.16pg/ml and 101.83±46.31pg/ml,which was separately in ACS group,SA group and control group.And the former was lower than the later two(P<0.001).Subgroup analysis of patients in ACS group: The expression of Serum IL-33 was 50.79±30.52pg/ml,55.98±31.13pg/ml and 63.10±20.70pg/m,which was separately in STEMI group,N-STEMI group and UA group.And the former was lower than the UA group(P<0.001).2.The expression of Serum s ST2 was 29.65±18.38ng/ml,23.10±12.54ng/ml and 20.67±8.38ng/ml,which was separately in ACS group,SA group and control group.And the former was higher than the later two(P<0.01).Subgroup analysis of patients in ACS group: The expression of Serum s ST2 was 35.74±19.84ng/ml,27.28±15.87ng/ml and 26.94±18.54ng/m,which was separately in STEMI group,N-STEMI group and UA group.And the former was higher than the later two(P<0.01).3.The expression of Plasma LPA was 3.22±1.84umo/L,2.19±1.27umo/L and1.51±1.10umo/L,which was separately in ACS group,SA group and control group.And the former was higher than the later two(P<0.01).Subgroup analysis of patients in ACS group:The expression of Plasma LPA was 3.88±2.04umo/L,2.96±1.68umo/L and 2.94±1.72umo/Ll,which was separately in STEMI group,N-STEMI group and UA group.And the former was higher than the later two(P<0.001).4.Correlation analysis of IL-33,s ST2,LPA and Gensini score in ACS group:IL-33 was negatively correlated with Gensini score(r=-0.333,P<0.001);s ST2,LPA were positively correlated with Gensini score(r=0.632,P<0.001.r = 0.428,P <0.001).5.We would analyze Multivariate Logistic regression,draw ROC curve and calculate AUC value:Multivariate Logistic regression analysis showed that IL-33,s ST2 and LPA were independent risk factor for ACS(P<0.001).The calculated values of the AUC area under the ROC curve and the optimal cutoff value were showed as follows:(1)The AUC of IL-33 was 0.794(OR=0.966,95%CI: 0.733-0.855,P<0.001),the optimal cutoff value was 70.26pg/ml,the sensitivity was 77.0%,and the specificity was 73.6%.(2)The AUC of s ST2 was 0.671(OR=1.035,95%CI: 0.6-0.743,P<0.001),the best critical value was 26.02ng/ml,the sensitivity was 50.8%,and the specificity was84.6%.(3)The AUC of LPA was 0.744(OR=1.775,95%CI: 0.678-0.811,P<0.001),the optimal critical value was 2.273umol/L,the sensitivity was 70.6%,and the specificity was 77.6%.(4)The AUC of IL-33 combined with s ST2 was 0.814(95%CI: 0.73-0.897,P<0.001),with a sensitivity of 76.2% and a specificity of 80.2%.(5)The AUC curve area of IL-33 combined with s ST2 L combined with LPA was0.855(95%CI: 0.806-0.903,P<0.034),with a sensitivity of 81.1% and a specificity of73.6%.Conclusion: 1.Serum IL-33 level in ACS patients is lower than that in SA and coronary normal patients,and lower in STEMI patients.IL-33 level is negatively correlated with the severity of coronary lesions.2.The level of serum s ST2 and LPA in ACS patients is higher than that in SA and normal coronary patients,and higher in STEMI patients.The level of s ST2 and LPA is positively correlated with the severity of coronary artery lesions.3.IL-33/s ST2 and LPA may diagnose the occurrence of ACS,and the combination of the three has a higher predictive value. |
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