Study On The Level And Clinical Significance Of HIGD-1A And HIGD-1B In Serum Of Patients With Acute Coronary Syndrome

Objective:The serum levels of HIGD-1A and HIGD-1B were measured in patients with Acute coronary syndrome(ACS),to explore the relationship between early diagnosis of acute coronary syndrome and severity of coronary artery disease.Method:1.Coronary heart disease and Acute coronary syndrome were confirmed at the Department of Cardiovascular Medicine,The First Affiliated Hospital of Bengbu Medical College from September 2019 to September 2021.Combined with the symptoms of chest tightness and pain,dynamic changes of electrocardiogram,myocardial enzyme pattern,troponin Ⅰ and other hematologic examinations,coronary atherosclastic heart disease and acute coronary syndrome were confirmed.126 patients with ACS,as subjects,successfully completed coronary angiography in the cardiac catheterization room of our hospital.According to the results of coronary angiography,patients with at least one coronary vessel lumen stenosis degree greater than or equal to 50% are diagnosed as coronary heart disease.Patients were further classified as Acute Myocardial infraction(myocardial infraction)based on clinical findings,ECG changes,troponin Ⅰ results,and intracavitary ultrasound results.There were 50 patients with AMI,56 patients with Unstable Angina Pectoris(UAP)and 20 patients with Stable Angina pectoris(SAP).In addition,34 patients with no abnormal coronary angiography in the same period were selected as the normal control group.2.After the informed consent of the patient,the name,sex,age,medical history and treatment of hypertension,diabetes,hyperlipidemia,family hereditary diseases and infectious diseases of all the examinees shall be collected;Laboratory results of blood pressure,blood glucose,blood routine and biochemical routine were collected upon admission.Two 5mL cubitus median venous blood samples were collected in the morning of the second day of admission.One sample was used for functional lipid and blood glucose analysis of liver and kidney,and the other sample was used for serum HIGD-1A and HIGD-1B protein levels of all subjects in the same batch by enzyme-linked immunosorbent assay.When the examiner successfully completed the coronary angiography,all findings and the coronary vascular lesions were recorded.3.IBM data processing software SPSS 25.0 was used for data processing and analysis.The measurement data conforming to normal distribution were expressed as mean ± standard deviation.T-test was used for comparison between two groups,and ANOVA single factor analysis of variance was used for comparison between multiple groups.Counting data were expressed as percentage,and chi-square test was used for comparison between groups.Pearson correlation analysis was used for correlation analysis.The Receiver Operating Characteristic curve(ROC)was used to evaluate the diagnostic significance of serum HIGD-1A and HIGD-1B proteins for ACS,and P<0.05 was considered as statistically significant difference.Results:1.In this study,the serum HIGD-1B protein level was(4.46±1.76 ng/mL)in patients with acute coronary syndrome(ACS)and(2.51±0.82 ng/mL)in patients with stable angina pectoris(SAP).The serum HIGD-1B protein level in normal group was(1.67±0.84ng/mL),and the difference between ACS group,SAP group and normal group was statistically significant(P < 0.001).The serum HIGD-1B protein level in ACS group was significantly higher than that in SAP group and normal group(P<0.05).After acute coronary syndrome(ACS)was divided into acute myocardial infarction(AMI)and unstable angina pectoris(UAP)subgroups,the serum HIGD-1B protein level in AMI group was(5.16±1.93ng/mL),and that in UAP group was(3.83±1.32ng/mL).Serum HIGD-1B protein of AMI was significantly higher than that of UAP group,and the difference between the two groups was statistically significant(t=-4.077,P<0.001).2.In this study,the serum HIGD-1A protein level was(2.67±0.90 ng/mL)in patients with acute coronary syndrome(ACS)and(2.26±0.63ng/mL)in patients with stable angina pecina(SAP).Serum HIGD-1A protein level in normal group was(2.53±0.78ng/mL),and there was no significant difference in serum HIGD-1A protein between ACS group,SAP group and normal group(P > 0.05).3.According to Gensini scores,patients in the ACS group were divided into 29 cases in the mild disease group(0-45 points),40 cases in the moderate disease group(46-90 points),and 37 cases in the severe disease group(>90 points).The serum HIGD-1B protein level was(3.02±1.22ng/mL)in the mild disease group,(3.96±0.91ng/mL)in the moderate disease group,and(6.12±1.48ng/mL)in the severe disease group.The variance analysis showed that the HIGD-1B level of patients with different degrees of coronary artery disease in the ACS group was significantly different(P < 0.001).The level of HIGD-1B in severe disease group and moderate disease group was significantly higher than that in mild disease group,and the level of serum HIGD1 B in severe disease group was higher than that in moderate disease group(P<0.05).4.According to Pearson correlation analysis,HIGD-1B protein level was positively correlated with Gensini score in the ACS group,with statistical significance(r=0.685,P < 0.001).The level of HIGD-1B in AMI group and UAP group was positively correlated with Gensini score,with statistical significance(r=0.797,P < 0.001;r=0.546,P < 0.05).5.The diagnostic significance of serum HIGD-1B protein level for ACS and AMI was evaluated by ROC curve.Serum HIGD-1B protein level diagnosis the Area Under Curve(AUC)of ACS was 0.94 and AMI was 0.95.The maximum tangent point of the ROC curve was selected as the truncation value,and the truncation value of acute coronary syndrome was predicted to be 2.94ng/mL,the sensitivity was 0.84,and the specificity was 0.94.The predictive cut-off value of acute myocardial infarction was 3.17ng/mL,the sensitivity was 0.82,the specificity was 0.97.Conclusion:The serum HIGD-1B protein level in patients with acute coronary syndrome was significantly higher than that in the control group,and was positively correlated with the severity of coronary artery disease.The serum HIGD-1B protein is of clinical significance in the diagnosis of acute coronary syndrome,especially in acute myocardial infarction.