Predictive value of lipoprotein-associated phospholipase A2 on perioperative myocardial injury in patients with stable angina after percutaneous coronary intervention / 介入放射学杂志

ABSTRACT

Objective To explore the correlation between lipoprotein-associated phospholipase A2 (Lp-PLA2) and perioperative myocardial injury (PMI),and to discuss the predictive value of Lp-PLA2 in patients with stable angina after percutaneous coronary intervention (PCI).Methods A total of 222 consecutive patients with stable angina,who were admitted to Yixing Municipal People's Hospital,Jiangsu Province,China to receive PCI during the period from June 2015 to March 2017,were enrolled in this study.The patients' baseline data as well as the distribution pattern of coronary lesions,were recorded.According to the paclitaxel-PCI and the surgical cooperative study (SYNTAX) score,the severity of target vascular lesions was assessed,which was classified into low score group (0 to 22 points),middle score group (23 to 32 points) and high score group (≥33 points).The preoperative blood lipid level and renal function,both preoperative and postoperative Troponin T (cTnT),high sensitive C reactive protein(hs-CRP),as well as the postoperative Lp-PLA2 were tested.Results After the procedure,the Lp-PLA2 levels in patients with normal cTnT value (n=155) and in patients with elevated cTnT value (n=67) were(122.21±43.80) ng/ml and (224.53±65.00) ng/ml respectively (P＜0.05).SYNTAX score analysis showed that low score group had 120 patients,middle score group had 78 patients and high score group had 24 patients,the Lp-PLA2 levels of the above three groups were (119.51±51.96) ng/ml,(178.67±61.49) ng/ml and (233.16±61.32) ng/ml respectively,the differences were statistically significant between each other among the three groups (P＜0.05).Pearson correlation analysis indicated that a parallel correlation existed between Lp-PLA2 levels and postoperative cTnT values (R=0.492,P＜0.05).Logistic regression analysis revealed that Lp-PLA2 was the independent risk factor for elevated cTnT value during the perioperative period of PCI (OR=7.377,95％CI=3.368-16.156,P＜0.05).The area under ROC curve of Lp-PLA2 was 0.896 (95％CI=0.874-0.945,P＜0.001),the best cut-off point was 179 ng/ml,and the sensitivity and specificity for the diagnosis of PMI were 92.2％ and 66.7％,respectively.Conclusion Lp-PLA2 levels are closely correlated with the increased cTnT values after PCI,and the preoperative high level of Lp-PLA2 is the independent risk factor for PMI after PCI.