Relationship between serum indoxyl sulfate,Clusterin and coronary artery lesions in patients with acute coronary syndrome and its predictive value for short-term prognosis
10.7683/xxyxyxb.2024.08.007
- VernacularTitle:血清硫酸吲哚酚、簇集蛋白与急性冠脉综合征患者冠状动脉病变的关系及对短期预后的预测价值
- Author:
Guanghui LIU
1
;
Youyou DU
;
Tao KONG
Author Information
1. 郑州大学第一附属医院心内科,河南 郑州 450012
- Keywords:
acute coronary syndrome;
indoxyl sulfate;
Clusterin;
coronary artery lesions
- From:
Journal of Xinxiang Medical College
2024;41(8):737-743
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between serum indoxyl sulfate(IS),Clusterin and coronary artery lesions in patients with acute coronary syndrome(ACS)and its predictive value for short-term prognosis.Methods A total of 120 ACS patients who were admitted to the First Affiliated Hospital of Zhengzhou University from June 2021 to October 2022 were selected as the research subjects(ACS group),and another 80 healthy volunteers who underwent physical examinations in our hospital during the same period were selected as the control group.Serum IS and Clusterin levels of patients in the ACS group and control group were detected by enzyme-linked immunosorbent assay.ACS patients were divided into a single-vessel disease group(n=43),a double-vessel disease group(n=49)and a multi-vessel disease group(n=28)according to the number of coronary artery lesions,divided into a mild lesion group(n=37),moderate lesion group(n=48)and severe lesion group(n=35)according to the Gensini score,and divided into a good prognosis group(n=85)and a poor prognosis group(n=35)according to the short-term prognosis.The influencing factors for poor short-term prognosis in ACS patients were analyzed by univariate and multivariate logistic regression,and the predictive value of serum IS and Clusterin levels for poor short-term prognosis in ACS patients was evaluated by receiver operating characteristic(ROC)curve.Results The serum IS and Clusterin levels of patients in the ACS group were significantly higher than those in the control group(P＜0.05).The serum IS and Clusterin levels of patients in the single-vessel disease group,double-vessel disease group and multi-vessel disease group increased in turn(P＜0.05).The serum IS and Clusterin levels of patients in the mild lesion group,moderate lesion group and severe lesion group increased in turn(P＜0.05).The incidence of poor short-term prognosis in 120 ACS patients was 29.17％(35/120).Univariate analysis showed that,ACS type,Gensini score,KILLIP grade,number of coronary artery lesions,IS,and Clusterin were related to the short-term prognosis in ACS patients(P＜0.05).Multivariate logistic regression analysis showed that,increased Gensini score,increased IS,increased Clusterin,KILLIP grade≥Ⅲ,and multi-vessel coronary artery disease were independent risk factors for poor short-term prognosis in ACS patients(P＜0.05).The area under the ROC curve(AUC)for predicting poor short-term prognosis in ACS patients based on serum IS level was 0.747(95％confidence interval:0.529-0.946),with sensitivity of 71.43％,specificity of 74.12％,accuracy of 73.33％,and Youden index of 0.455.The AUC for predicting poor short-term prognosis in ACS patients based on serum Clusterin level was 0.693(95％confidence interval:0.439-0.951),with sensitivity of 68.57％,specificity of 70.59％,accuracy of 7.00％,and Youden index of 0.392.The AUC for predicting poor short-term prognosis in ACS patients based on both serum IS and Clusterin levels was 0.825(95％confidence interval:0.687-0.968),with sensitivity of 82.86％,specificity of 83.53％,accuracy of 83.33％,and Youden index of 0.664.Conclusion Increased serum IS and Clusterin levels are associated with aggravation of coronary artery disease and poor short-term prognosis in ACS patients,and a combination of the two has a high predictive value for poor short-term prognosis in ACS patients.
