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The Relationship between Lipoprotein (a), High-sensitivity C-reactive Protein, Apolipoprotein A1/Apolipoprotein B and Acute Coronary Syndrome

Author: GaoZuo
Tutor: LiuJun
School: Dalian Medical University
Course: Internal Medicine
Keywords: Acute coronary syndrome Lipoprotein (a) High sensitivity C reactive protein ApoA1/ApoB Gensini score
CLC: R543.3
Type: Master's thesis
Year: 2013
Downloads: 20
Quote: 0
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Abstract


Objective: Determination the plasma lipoprotein (a)[Lp (a)], high-sensitivityC-reactive protein (hs-CRP), apolipoprotein A1(ApoA1) apolipoprotein B (ApoB)level of acute coronary syndrome (ACS) patients, To investigate the role of Lp (a)hs-CRP, ApoA1/ApoB in acute coronary syndrome (ACS) and the relationshipbetween the severity of coronary disease and coronary artery disease the severity.Methods: Select120patients with coronary atherosclerotic heart disease (CAD),patients admitted by into the Department of Cardiology Department of the FirstAffiliated Hospital of Dalian Medical University from2012June to2011October,were recruited. The diagnosis of CAD conforms to the diagnostic criteria (2007) ofthe American College of Cardiology/American Heart Association (ACC/AHA)2007diagnostic criteria. Divided them into acute ST segment elevation myocardialinfarction (STEMI) group, acute non ST segment elevation myocardial infarction(NSTEMI) group, unstable angina pectoris (UAP) group and stable angina pectoris(SAP) group, with30cases in each group. In addition, another30subjects cases dueto with chest pain, but no coronary heart disease confirmed by coronary angiography(Coronary angiography, CAG) proved to be non coronary heart disease were assignedinto the control group. The blood samples were sucked from the ulnar vein in allpatient subjects after12hours of fasting in the on Day2of hospital determination ofthe liver hepatic function, renal function, blood lipid, Lp (a), hs-CRP, ApoA1, ApoBlevels. All the patient subjects underwent coronary CAG angiography, and calculatingthe severity of coronary stenosis Gensini score.Data were processed by statisticalsoftware SPSS17.0. Count the numeration data is were express presented in thenumber of cases (ratio), and compared with by χ2test among the different groups,compared with count data usingχ2test;. The normality and homogeneity of variancefirst of all, the of measurement data were analyzed test of normality and homogeneity of variance test, then it is expressed into and presented with the mean±standarddeviation. Lp (a),and hs-CRP showed a skewed distribution., and they showednormal distribution after logarithmic transformation., each group data using singlefactor analysis of variance was used to analyze the data of each group, and LSD testwas a further used to compare the data between two every two groups compared withLSD test, in addition, statistically significant variables and Gensini scores coronaryartery score will be meaningful for were processed with the multiple stepwiseregression analysis, the correlation between two variables using with the Pearson orSpearman correlation analysis, P<0.05had was statistical significance..Results:1. Comparison in the plasma levels of hs-CRP, and ApoA1/ApoB:(1):The plasma levels of hs-CRP, and ApoA1/ApoB in STEMI group, NSTEMI groupand UAP group were significantly different, compared with those in the SAP groupand control group had significant difference, P<0.01; there was no significantdifference in among the STEMI group, the group NSTEMI group and the group UAPgroup had, P>0.05; The difference between the group SAP group and the controlgroup had no was not significant difference, P>0.05.(2) The plasma levels ofhs-CRP in STEMI group and the NSTEMI group were significantly different,compared with the control group, P<0.01; The difference between the STEMI group,and the NSTEMI group had no was not significant, P>0.05.(3)The plasma levels ofhs-CRP in UAP group, SAP group were significantly different, compared with that ofthe control group had significant difference, P<0.05; The difference between UAPgroup and SAP group had no was not significant difference.(4) The plasma levels ofhs-CRP in STEMI group and NSTEMI group compared with UAP group and SAPgroup had a significant difference, P<0.05.2. The severity of coronary artery stenosis was evaluated with Gensiniscore, which was and positively correlated the serum Lp (a) level (r=0.5, P=0.00)and, the positive correlation between hs-CRP levels (r=0.266, P=0.001); Gensiniscore was negatively correlated with the ApoA1/ApoB ratio (r=-0.310, P=0.000).3. The severity of coronary artery stenosis Gensini score and the serumLp (a), hs-CRP, ApoA1/ApoB levels were analyzed by multiple stepwise regressionanalysis The results showed that Lp (a), ApoA1/ApoB were entered into theregression equation: Gensini score=0.029Lp (a)-21.089ApoA1/ApoB+35.296.Therefore Lp (a) showed a strengther of these two factors influence on the severity of coronary artery stenosis in the order of Lp (a),than apoA1/apoB. Hs-CRP has was notentered into the regression equation.4. The plasma levels of Lp (a) and ApoA1/ApoB were not correlatedwith those of total cholesterol (Total cholesterol, TC), triglyceride (Triglyceride, TG),high density lipoprotein cholesterol (High density lipoprotein cholesterol, HDL-C),low density lipoprotein cholesterol (Low density lipoprotein cholesterol, LDL-C),P>0.05.Conclusion:1. The levels of Lp(a) and hs-CRP in patients with acute coronarysyndrome in peripheral blood were significantly increased in peripheral blood, theratio of ApoA1/ApoB in patients with acute coronary syndrome decreased inperipheral blood.2. Lp(a), hs-CRP, apoA1/apoB can be used as a indicatorsreference index to predict evaluate the risk of coronary heart disease and coronaryartery disease the severity.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Vascular disease > Coronary venous disease
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