Cheng Minju, Cheng Minjing, Wei Qingmin
Department of Cardiology, Xingtai People's Hospital, Xingtai, Hebei 054000, P.R. China.
Department of Cardiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China.
Exp Ther Med. 2020 Aug;20(2):1532-1540. doi: 10.3892/etm.2020.8817. Epub 2020 May 29.
In the present study, the association between the severity of coronary artery disease (CAD) and myeloperoxidase (MPO), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) was assessed and their diagnostic and prognostic value was determined. A total of 112 patients with CAD [patient group (PG)] and 112 healthy participants who visited the hospital for physical examinations [control group (CG)] were enrolled in the present study. The plasma levels of MPO, Hcy and hs-CRP were compared between the two groups. According to the arteriography results, the patients were further divided into the single-vessel disease group (SVG), double-vessel disease group (DVG) and multi-vessel disease group (MVG). The Gensini scores of the three groups were evaluated according to the Gensini score standard. The correlations between the expression of MPO, Hcy or hs-CRP and the Gensini score of the PG were analyzed. The patients' major adverse cardiovascular event (MACEs) were recorded over 6 months and compared, and the predictive values of MPO, Hcy and hs-CRP regarding MACEs were determined by receiver operating characteristics analysis. The results indicated that the levels of MPO, Hcy and hs-CRP in the PG were higher than those in the CG (P<0.05). The Gensini score and the expression of MPO, Hcy and hs-CRP in the MVG were higher than those in the SVG and the DVG, and the Gensini score and the expression of MPO, Hcy and hs-CRP in the DVG were higher than those in the SVG (P<0.05). There was a positive correlation between the Gensini score and the expression of MPO (r=0.814, P<0.05), Hcy (r=0.774, P<0.05) and hs-CRP (r=0.765, P<0.05) in the PG. The total incidence of MACEs in patients with multiple lesions was significantly higher than that in patients with double and single lesions (P<0.05). The total incidence of MACEs in the MVG group was higher than that in the SVG and the DVG, and the total incidence of MACEs in the DVG was higher than that in the SVG (P<0.05). The area under the curve (AUC) and sensitivity for MPO levels to predict MACEs were higher than those of Hcy and hs-CRP (P<0.05); however, there was no significant difference in the AUC and sensitivity of Hcy and hs-CRP for predicting MACEs (P<0.05). The specificity of hs-CRP for predicting MACEs was higher than that of MPO and Hcy (P<0.05). The number of lesions, hypertension, diabetes, MPO, Hys and hs-CRP were determined to be independent risk factors for MACEs. In conclusion, for patients with CAD, elevated plasma levels of MPO, Hcy and hs-CRP were directly correlated with the severity of CAD and the risk of MACEs. Furthermore, MPO, Hcy and hs-CRP may effectively predict MACEs and are of important clinical significance in terms of judging the condition and improving the prognosis for patients with CAD.
在本研究中，评估了冠状动脉疾病（CAD）的严重程度与髓过氧化物酶（MPO）、同型半胱氨酸（Hcy）和高敏C反应蛋白（hs-CRP）之间的关联，并确定了它们的诊断和预后价值。本研究共纳入112例CAD患者[患者组（PG）]和112名因体检来医院就诊的健康参与者[对照组（CG）]。比较了两组患者MPO、Hcy和hs-CRP的血浆水平。根据血管造影结果，将患者进一步分为单支血管病变组（SVG）、双支血管病变组（DVG）和多支血管病变组（MVG）。根据Gensini评分标准评估三组的Gensini评分。分析了PG中MPO、Hcy或hs-CRP的表达与Gensini评分之间的相关性。记录患者6个月内的主要不良心血管事件（MACEs）并进行比较，通过受试者工作特征分析确定MPO、Hcy和hs-CRP对MACEs的预测价值。结果表明，PG中MPO、Hcy和hs-CRP的水平高于CG（P<0.05）。MVG中的Gensini评分以及MPO、Hcy和hs-CRP的表达高于SVG和DVG，DVG中的Gensini评分以及MPO、Hcy和hs-CRP的表达高于SVG（P<0.05）。PG中Gensini评分与MPO表达（r=0.814，P<0.05）、Hcy表达（r=0.774，P<0.05）和hs-CRP表达（r=0.765，P<0.05）呈正相关。多支病变患者MACEs的总发生率显著高于双支和单支病变患者（P<0.05）。MVG组MACEs的总发生率高于SVG和DVG，DVG组MACEs的总发生率高于SVG（P<0.05）。MPO水平预测MACEs的曲线下面积（AUC）和敏感度高于Hcy和hs-CRP（P<0.05）；然而，Hcy和hs-CRP预测MACEs的AUC和敏感度无显著差异（P>0.05）。hs-CRP预测MACEs的特异性高于MPO和Hcy（P<0.05）。病变数量、高血压、糖尿病、MPO、Hys和hs-CRP被确定为MACEs的独立危险因素。总之，对于CAD患者，MPO、Hcy和hs-CRP的血浆水平升高与CAD的严重程度和MACEs风险直接相关。此外，MPO、Hcy和hs-CRP可有效预测MACEs，在判断CAD患者病情和改善预后方面具有重要临床意义。
