Relationship between serum levels of complement C3,C4 and C5b-9 and myocardial injury in patients with acute coronary syndrome / 中国综合临床

ABSTRACT

Objective To investigate the correlation of serum complement C3,C4 and C5b-9 levels with myocardial injury in patients with Acute Coronary Syndrome( ACS) . Methods From July 2015 to July 2017, one hundred and eighty patients with ACS admitted to the Department of Cardiology,the 425th Hospital of PLA Sanyawere selected,including 80 patients with non-ST-elevation ACS ( NSTE-ACS group) and 100 patients with ST-elevation myocardial infarction ( STEMI group ) . The content of cardiac troponin T ( TnT ) , creatine kinase isoenzyme (CK-MB),N terminal B type natriuretic peptide precursor (NT-proBNP),fibrinogen (Fib),soluble intercellular adhesion analysis 1 ( sICAM 1 ) , left ventricular ejection fraction ( LVEF ) were measured in the patients according to the global acute coronary event registration ( GRACE) score. The levels of complement C3, C4 and C5b-9 were measured by ELISA at 1,3 and 7 days after admission. Results Comparing the two groups, the smoking history of group STEMI was 33. 00％,significantly lower than that of group NSTE-ACS 61. 25％ ( P<0. 01) . The level of TnT,CK-MB,sICAM 1 and NT-proBNP in group STEMI was significantly lower than that in group NSTE-ACS ( t=60. 686,64. 010,47. 824,12. 975,P=0. 001) ,and the level of LVEF was significantly higher than that in the NSTE-ACS group ( t=10. 560,P=0. 001) . The levels of C3,C4 and C5b-9 in STEMI group were significantly higher than those in NSTE-ACS group (12. 946,8. 965,18. 125 in F group,P<0. 05), and the levels of C4 and C5b-9 in STEMI group were significantly higher than those in NSTE-ACS group on the 3rd and 7th day of onset ( P<0. 05) . According to GRACE score,there were significant differences in troponin T,soluble intercellular adhesion molecule 1,left ventricular ejection fraction,C3 and C4 among low-risk group, middle-risk group and high-risk group ( F=107. 636, 338. 866, 21. 708, 10. 923, 3. 229, P=0. 001 ) , Soluble intercellular adhesion molecule 1 ( SIAM 1) in high-risk group and middle-risk group was significantly higher than that in low-risk group. Troponin T, SIAM 1, C3 and C4 in high-risk group were significantly higher than those in the other two groups,while left ventricular ejection fraction was significantly lower than those in the other two groups ( P<0. 05 ) . The levels of C3, C4, C5b-9 were positively correlated with troponin T and soluble intercellular adhesion molecule 1 ( r=0. 488, 0. 358, 0. 291, 0. 297, 0. 251, 0. 289, P<0. 05 ) , and negatively correlated with left ventricular ejection fraction ( r=- 0. 392,-0. 259,-0. 215,P<0. 05) . Epithelial molecule 1 was correlated with left ventricular ejection fraction ( r=-0. 340,P=0. 001) ,and soluble intercellular adhesion molecule 1 was correlated with troponin T ( r=0. 533,P=0. 001) . Conclusion The activation mechanism of complement system in acute ischemic necrosis and its relationship with inflammatory factors have important clinical research value. C3,C4 and C5b-9 as an important component of complement system may be involved in the process of myocardial injury,and can be used as an indicator of myocardial injury.