Plasma αl-antitrypsin： A Neglected Predictor of Angiographic Severity in Patients with Stable Angina Pectoris  

作　　者：Hui Zhao Hong Liu Lin Chai Ping Xu Lu Hua Xiao-Yuan Guan Bing Duan Yi-Ling Huang Yi-Shi Li 

机构地区：[1]Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China

出　　处：《Chinese Medical Journal》2015年第6期755-761,共7页中华医学杂志（英文版）

摘　　要：Background:As an acute phase protein,α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome,but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP).The purpose of the present study was to investigate the association between AAT plasma levels and SAP.Methods:Overall,103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study.Plasma levels of AAT,high-sensitivity C-reactive protein (hsCRP),lipid profiles and other clinical parameters were assayed for all participants.The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography.Results:Positively correlated with the GS (r =0.564,P ＜ 0.001),the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs.125.50 ± 19.67 mg/dl,P ＜ 0.001).The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] =1.037,95％ confidence interval [CO:1.020-1.054,P ＜ 0.001) and a high GS (OR =1.087,95％ CI:1.051-1.124,P ＜ 0.001) in a multivariate logistic regression model.In the receiver operating characteristic curve analysis,plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC =0.858,95％ CI:0.788-0.929,P ＜ 0.001) than that of hsCRP (AUC =0.665,95％ CI:0.557-0.773,P =0.006; Z =2.9363,P ＜ 0.001),with an optimal cut-off value of 137.85 mg/dl (sensitivity:94.3％,specificity:68.2％).Conclusions:Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP,suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.Background:As an acute phase protein,α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome,but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP).The purpose of the present study was to investigate the association between AAT plasma levels and SAP.Methods:Overall,103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study.Plasma levels of AAT,high-sensitivity C-reactive protein (hsCRP),lipid profiles and other clinical parameters were assayed for all participants.The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography.Results:Positively correlated with the GS (r =0.564,P ＜ 0.001),the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs.125.50 ± 19.67 mg/dl,P ＜ 0.001).The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] =1.037,95％ confidence interval [CO:1.020-1.054,P ＜ 0.001) and a high GS (OR =1.087,95％ CI:1.051-1.124,P ＜ 0.001) in a multivariate logistic regression model.In the receiver operating characteristic curve analysis,plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC =0.858,95％ CI:0.788-0.929,P ＜ 0.001) than that of hsCRP (AUC =0.665,95％ CI:0.557-0.773,P =0.006; Z =2.9363,P ＜ 0.001),with an optimal cut-off value of 137.85 mg/dl (sensitivity:94.3％,specificity:68.2％).Conclusions:Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP,suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.

关 键 词：Α1-ANTITRYPSIN ANGIOGRAPHY Coronary Artery Disease Gensini Score Inflammation Stable ANGINA PECTORIS 

分 类 号：R[医药卫生]