Objective To investigate the relationship of serum levels of GRP78 and ICTP with the severity and prognosis of coronary artery disease in elderly patients with acute coronary syndrome(ACS).Methods A total of 195 elderly ACS patients(all receiving PCI)admitted in Department of Geriatrics of Wuhan Wuchang Hospital from June 2021 to June 2023 were enrolled and served as an ACS group.They were 56 ones of mild,75 of moderate and 64 of severe conditions,and 51 patients were in poor prognosis and 144 patients in good prognosis.Another 198 healthy individu-als taking health checkup during the same period served as a control group.ELISA was used to de-tect serum levels of GRP78 and ICTP.The serum levels were compared between the ACS group and the control group,in elderly ACS patients with different severity and different prognoses,and in these patients before and after treatment.Pearson correlation analysis was used,multivariate lo-gistic regression analysis and ROC curve analysis were applied for statistical analyses.Results The serum levels of GRP78 and ICTP were significantly higher in the ACS group than the control group(P＜0.01),and in the severe patients than the moderate and mild patients(P＜0.05).When compared with the patients with good prognosis,those with poor prognosis had notably higher serum levels of GRP78 and ICTP at both before and after treatment(P＜0.01),higher cTnI level and Gensini score,and lower LVEF(P＜0.01).Pearson correlation analysis showed that in elderly ACS patients the serum levels of GRP78 and ICTP were positively correlated with cTnI and Gensini score,and negatively with LVEF(P＜0.01).GRP78 and ICTP were independent risk fac-tors for poor prognosis in elderly ACS patients(OR=2.978,95％CI:1.581-5.609,P=0.001;OR=3.012,95％CI:1.493-6.076,P=0.002).ROC curve analysis indicated that the AUC value of GRP78,ICTP and their combination in predicting poor prognosis in elderly ACS patients was 0.834,0.840,and 0.938,respectively,with a sensitivity of 80.41％,80.43％and 92.28％,and a spe-cificity of 77.15％,76.48％,and 82.64％,respectively.The combination prediction obtained better AUC value than single indicator(Z=2.611,2.516,P＜0.05).The AUC value of cTnI in predicting poor prognosis in elderly ACS patients was 0.824,with a sensitivity of 76.59％and a specificity of 77.16％.The AUC value of cTnI is not better than that of GRP78 and ICTP,and there was no sta-tistical difference(Z=0.199,0.323,P＞0.05).Conclusion High serum GRP78 and ICTP levels in elderly ACS patients are closely associated with the severity of coronary artery disease,and their combination can effectively predict poor prognosis in the patients.

Objective To investigate the relationship of serum levels of GRP78 and ICTP with the severity and prognosis of coronary artery disease in elderly patients with acute coronary syndrome(ACS).Methods A total of 195 elderly ACS patients(all receiving PCI)admitted in Department of Geriatrics of Wuhan Wuchang Hospital from June 2021 to June 2023 were enrolled and served as an ACS group.They were 56 ones of mild,75 of moderate and 64 of severe conditions,and 51 patients were in poor prognosis and 144 patients in good prognosis.Another 198 healthy individu-als taking health checkup during the same period served as a control group.ELISA was used to de-tect serum levels of GRP78 and ICTP.The serum levels were compared between the ACS group and the control group,in elderly ACS patients with different severity and different prognoses,and in these patients before and after treatment.Pearson correlation analysis was used,multivariate lo-gistic regression analysis and ROC curve analysis were applied for statistical analyses.Results The serum levels of GRP78 and ICTP were significantly higher in the ACS group than the control group(P＜0.01),and in the severe patients than the moderate and mild patients(P＜0.05).When compared with the patients with good prognosis,those with poor prognosis had notably higher serum levels of GRP78 and ICTP at both before and after treatment(P＜0.01),higher cTnI level and Gensini score,and lower LVEF(P＜0.01).Pearson correlation analysis showed that in elderly ACS patients the serum levels of GRP78 and ICTP were positively correlated with cTnI and Gensini score,and negatively with LVEF(P＜0.01).GRP78 and ICTP were independent risk fac-tors for poor prognosis in elderly ACS patients(OR=2.978,95％CI:1.581-5.609,P=0.001;OR=3.012,95％CI:1.493-6.076,P=0.002).ROC curve analysis indicated that the AUC value of GRP78,ICTP and their combination in predicting poor prognosis in elderly ACS patients was 0.834,0.840,and 0.938,respectively,with a sensitivity of 80.41％,80.43％and 92.28％,and a spe-cificity of 77.15％,76.48％,and 82.64％,respectively.The combination prediction obtained better AUC value than single indicator(Z=2.611,2.516,P＜0.05).The AUC value of cTnI in predicting poor prognosis in elderly ACS patients was 0.824,with a sensitivity of 76.59％and a specificity of 77.16％.The AUC value of cTnI is not better than that of GRP78 and ICTP,and there was no sta-tistical difference(Z=0.199,0.323,P＞0.05).Conclusion High serum GRP78 and ICTP levels in elderly ACS patients are closely associated with the severity of coronary artery disease,and their combination can effectively predict poor prognosis in the patients.