Application Value of Plasma Lipoprotein-associated Phospholipase A2 Level and AT- Ⅲ Activity on Risk Stratification and Nearby Risk Assessment in Patients With Non-ST Segment Elevation Acute Coronary Syndrome
10.3969/j.issn.1000-3614.2017.12.006
- VernacularTitle:血浆脂蛋白相关磷脂酶A2水平和抗凝血酶Ⅲ活性对非ST段抬高型急性冠状动脉综合征患者危险分层及近期风险评估的应用价值
- Author:
dan Dan NIU
1
;
hua Wen LI
;
Di ZHENG
;
Quan ZHANG
;
Hu WANG
Author Information
1. 徐州医科大学附属医院 心内科
- Keywords:
Acute coronary syndrome;
Phospholipase A2;
Antithrombin Ⅲ;
GRACE score
- From:
Chinese Circulation Journal
2017;32(12):1167-1171
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) level, antithrombinⅢ (AT-Ⅲ ) activity and global registry of acute coronary events (GRACE) score in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS); to analyze the predictive value of Lp-PLA2, AT- Ⅲ on risk stratification and nearby risk assessment in NSTE-ACS patients. Methods: Our research included in 2 groups: NSTE-ACS group, n=260 patients with confirmed diagnosis and regular treatment; Control group, n=50 in-hospital patients with coronary angiography excluded coronary artery disease (CAD).plasma level of Lp-PLA2 and AT-Ⅲ activity were examined in the next morning of admission. GRACE score was calculated in NSTE-ACS patients and based on GRACE score, NSTE-ACS group was further divided into 3 subgroups as Low risk subgroup, GRACE score≤108, n=121, Middle risk subgroup, GRACE score (109-140), n=73 and High risk subgroup, GRACE score>140, n=66. The relationships between Lp-PLA2 level, AT-Ⅲ activity and GRACE score were evaluated and the occurrence of major adverse cardiovascular events (MACE) was recorded within 3 months of discharge. Results: ① Compared with Control group, NSTE-ACS group had increased Lp-PLA2 level, P<0.05 and decreased AT-Ⅲ activity, P<0.01. ② In NSTE-ACS group, Lp-PLA2 levels were elevating from Low risk subgroup to Middle risk subgroup and to High risk subgroup accordingly, all P<0.01; compared with Low risk and Middle risk subgroups, High risk subgroup showed decreased AT-Ⅲ activity, P<0.01 and P<0.05; while AT-Ⅲ activity was similar between Low risk and Middle risk subgroups, P>0.05. ③Partial correlation analysis presented that GRACE score was positively related to Lp-PLA2 (r=0.641, P=0.000) and negatively related AT-III (r=-0.179, P=0.006). ④ The area under ROC curve for MACE occurrence in GRACE score was 0.811, in Lp-PLA2 was 0.862 and in AT- Ⅲ was 0.631, all P<0.01; multivariate Logistic regression analysis indicated that Lp-PLA2, GRACE score and HDL-C were the independent predictors for nearby MACE occurrence in NSTE-ACS patients. Conclusion: Blood Lp-PLA2 level and AT-Ⅲ activity were important for risk stratification in NSTE-ACS patients;AT- Ⅲ had less value than Lp-PLA2 and GRACE score for nearby risk assessment.
