老年急性冠状动脉综合征患者生长分化因子15与冠状动脉病变程度和预后关系

Correlation of serum growth differentiation factor-15 level with degree of coronary artery lesion and prognosis in elderly patients with acute coronary syndrome

目的分析生长分化因子-15(GDF-15)水平对老年急性冠状动脉(冠脉)综合征患者冠状动脉病变程度及预后的影响。方法前瞻性病例对照研究,选取杭州市西溪医院和浙江大学附属邵逸夫医院2017年3月至2018年4月收治的168例老年急性冠状动脉综合征患者。按GDF-15水平分为>1800μmol/L组28例,1200~1800μmol/L组45例,<1200μmol/L组95例。对比分析3组患者超敏C反应蛋白(hs-CRP)、GDF-15、SYNTAX积分、单支病变、双支病变、多支病变及主要不良心血管事件(MACE)等临床资料。结果>1800μmol/L组、1200~1800μmol/L组、<1200μmol/L组患者hs-CRP、GDF-15水平比较差异有统计学意义(均P<0.05);SYNTAX积分、单支病变、双支病变、多支病变及主要不良心血管事件(MACE)比较差异亦有统计学意义(均P<0.05)。Logistic回归分析结果显示,GDF-15水平(OR=2.092,95%CI:1.585~2.687)、SYNTAX积分(OR=1.948,95%CI:1.097~2.098)、双支病变(OR=1.124,95%CI:1.006~1.251)、多支病变(OR=1.744,95%CI:1.149~2.642)为影响患者预后的因素(均P<0.05)。结论GDF-15水平与SYNTAX积分、双支病变和多支病变具有相关性,对急性冠状动脉综合征患者冠状动脉病变程度及预后有预测作用。

Objective To analyze the correlation of growth differentiation factor-15(GDF-15)level with the severity of coronary artery disease and prognosis and in elderly patients with acute coronary syndrome.Methods A total of 168 elderly patients with acute coronary syndrome admitted into Hangzhou Xixi Hospital and Shaoyifu Hospital Affiliated to Medical College of Zhejiang University from March 2017 to April 2018 were enrolled in the study.Patients were divided into three groups:GDF-15>1800μmol/L(n=28),GDF-15 between 1200-1800μmol/L(n=45),and GDF-15<1200μmol/L(n=95).Plasma levels of high-sensitivity C-reactive protein(hs-CRP)and GDF-15,and SYNTAX score,single-vessel-,double-vessel,multi-vessel coronary disease and major adverse cardiovascular events(MACE)were analyzed and compared between groups.Results Plasma levels of hs-CRP and GDF-15 had significant differences among the three groups(P<0.05).There were significant statistically differences in SYNTAX score,single-vessel,double-vessel and multi-vessel coronary disease and MACE among the three groups(P<0.05).Logistic regression analysis showed that the levels of GDF-15(OR=2.092,95%CI:1.585~2.687),SYNTAX score(OR=1.948,95%CI:1.097~2.098),double-vessel lesions(OR=1.124,95%CI:1.006~1.251)and multi-vessel lesions(OR=1.744,95%CI:1.149~2.642)(all P<0.05)were statistically significant influencing factors for the prognosis.Conclusions GDF-15 level is correlated with SYNTAX score,double-vessel lesions and multi-vessel lesions,and could predict the severity of coronary artery lesions and prognosis in patients with acute coronary syndrome.