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. 2018 Dec;9(6):517-522.
doi: 10.3892/br.2018.1162. Epub 2018 Oct 19.

Predictive value of combining the level of lipoprotein-associated phospholipase A2 and antithrombin III for acute coronary syndrome risk

Jinyang Lu  1 , Dandan Niu  2 , Di Zheng  1 , Quan Zhang  1 , Wenhua Li  1
Affiliations

Predictive value of combining the level of lipoprotein-associated phospholipase A2 and antithrombin III for acute coronary syndrome risk

Jinyang Lu et al. Biomed Rep. 2018 Dec.

Abstract

The aim of the present study was to observe the role of lipoprotein-associated phospholipase A2 (Lp-PLA2) and antithrombin III (AT-III) in patients with acute coronary syndrome (ACS), and the combination of Global Registry of Acute Coronary Events (GRACE) score to determine the value of coronary heart disease risk stratification. A total of 309 patients admitted to the Affiliated Hospital of Xuzhou Medical University were enrolled. The patients were divided into two groups: The ACS (183 cases) and control (126 cases) groups. Blood levels of Lp-PLA2 and AT-III were measured. Based on GRACE score, the patients with ACS were divided into three subgroups: Low risk (GRACE score ≤108), middle risk (GRACE score 109-140) and high risk (GRACE score >140). The levels of Lp-PLA2 and AT-III were compared among different groups, and based on Gensini score, patients with ACS were divided into four groups by quartiles. Lp-PLA2 levels in the ACS group were significantly increased compared with the control group (P<0.05), but the AT-III levels were decreased compared with the control group (P<0.05). In the ACS group, Lp-PLA2 levels increased sequentially from the low risk to high risk subgroups (all P<0.05); compared with the low risk and middle risk subgroups, the AT-III activity levels were decreased in the high risk subgroup, and the Gensini scores were increased (all P<0.05). In the ACS group, with the increase of Gensini scores, the levels of Lp-PLA2 and AT-III exhibited increasing and decreasing trends, respectively (P<0.05). The logistic regression model demonstrated that Lp-PLA2 [odds ratio (OR) =1.077; P<0.001]; and GRACE score (OR=1.026; P=0.028) were risk factors, while AT-III was a protective factor (OR=0.958; P=0.012) for ACS. Correlation analysis indicated a positive association of Lp-PLA2 level with Gensini scores (r=0.52; P<0.01) and GRACE score (r=0.48; P<0.01), and a negative association between AT-III level and Gensini scores (r=-0.25; P<0.01) and GRACE scores (r=-0.34; P<0.01). The levels of Lp-PLA2 and AT-III exhibited predictive values in patients with ACS, and are associated with the severity of coronary artery stenosis.

Keywords: GRACE score; acute coronary syndrome; antithrombin III; lipoprotein-associated phospholipase A2.

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