| Objective:The correlation of TG,Non-HDL-C and Apo B levels in Asymptomatic Coronary Artery Disease(A-CAD)was analyzed.To explore the correlation between TG,Non-HDL-C and Apo B and the degree of A-CAD coronary artery lesions and their predictive value for early screening.Methods:Patients from the Cardiovascular Disease Centre of the Affiliated Hospital of Yan’an University between January 2021 and January 2023 were selected according to the NPA criteria,and all patients were examined by CTA or Coronary Angiography(Coronary Angiography,CAG).According to the results of CTA or CAG,they were divided into two groups:asymptomatic coronary heart disease group(A-CAD,n=279 cases)and non-coronary heart disease group(Non-coronary heart,NCAD,n=101 cases)stenosis<50%).The differences of clinical data between A-CAD group and NCAD group were compared.Patients with A-CAD were divided into Single-vessel disease(SVD),double-vessel disease(DVD)and Multivessel disease(MVD)according to the number of involved branch vessels.Three vessel lesions and left main stem were included.To compare the distribution of TG,Non-HDL-C and Apo B levels in patients with different number of lesion branches;to analyze the correlation between TG,Non-HDL-C and Apo B levels and GENSINI score using spearman correlation.The A-CAD group was divided into 139 cases with low GENSINI score(<12 points)and140 cases with high GENSINI score(≥12 points).Through ROC curve,The predictive value of plasma TG,Non-HDL-C and Apo B levels to the grouping of high GENSINI scores was analyzed,and the independent influencing factors of high GENSINI scores were analyzed by Logistic regression.Results:1.The concentrations of TG,Non-HDL-C and Apo B in asymptomatic coronary heart disease(A-CAD)group were higher than those in non-coronary heart disease(NCAD)group,and the levels of Non-HDL-C and Apo B increased gradually with the increase of the number of coronary artery lesions.2.The level of Apo B in patients with different number of lesions showed MVD>DVD>SVD(P<0.001);Both TG and Non-HDL-C showed MVD/DVD>SVD(P<0.001).3.Apo B,Non-HDL-C and TG levels in A-CAD group were significantly correlated with GENSINI score(r_s=0.494;r_s=0.420;r_s=0.403,P<0.001).4.The concentrations of TG,Non-HDL-C and Apo B in low GENSINI group were lower than those in high GENSINI group(2.09(1.87,2.55,)vs1.89(1.65,2.13),P<0.001;4.09(3.30,4.92)vs3.12(2.65,3.93),P<0.001);1.38(0.84,1.67)vs 0.86(0.63,1.12),P<0.001).5.The ROC curve was used to analyze the predictive value of TG,Non-HDL-C,Apo B and their combination in the group with high GENSINI score.The results showed that the areas under the ROC curve were(AUC)=0.664(95%CI:0.601-0.727,P<0.001)and(AUC)=0.707 respectively.P<0.001)、(AUC)=0.720(95%CI:0.660-0.780,P=0.001)、(AUC)=0.776(95%CI:0.723-0.829,P<0.001)。When TG=1.985,the maximum Jordan index is 0.277,and the sensitivity and specificity are 58.6%and 69.1%respectively.When Non-HDL-C=3.295,the maximum Jordan index is 0.325,and the sensitivity and specificity are 75.7%and 56.8%respectively.When Apo B=1.365,the maximum Jordan index is 0.399(sensitivity 52.1%,specificity 87.8%);When the combined value of the three is 6.655,the maximum Jordan index is 0.398,and the sensitivity is 74.3%.6.Multivariate Logistic regression analysis showed that high Apo B,Non-HDL-C and TG levels were independent factors of high GENSINI rating group(OR=3.561,95%CI=1.921～6.600,P<0.001;OR=1.772,95%CI=1.338～2.347,P<0.001;OR=2.201,95%CI=1.361～3.560,P=0.001).Conclusion:The plasma levels of TG,Non-HDL-C and Apo B are significantly correlated with the degree of coronary artery disease in A-CAD patients,which can reflect the degree of coronary artery disease and can be used as A clinical detection index for coronary artery disease.When the three are combined,the curve area is the largest,and the prediction value of A-CAD is the best.TG,Non-HDL-C and Apo B have important clinical significance for early screening and prevention of A-CAD. |
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