Relationships of indicators such as level of plasma lipoprotein-associated phospholipase A2 with effect of extracorporeal counterpulsation therapy in high-risk patients with coronary heart disease

  Objective  To study changes of plasma lipoprotein associated phospholipase A2 (Lp-PLA2), soluble lipoprotein receptor-associated protein 1 (sLRP-1), visfatin in high-risk patients with coronary heart disease and their effects on the outcomes of enhanced external counterpulsation therapy.

  Methods  A total of 94 patients with high risk of coronary heart disease admitted to our hospital were selected as observation group, and 80 healthy subjects in our hospital during the same period were selected as control group. Plasma Lp-PLA2, sLRP-1, visfatin, blood lipid indicatorstriglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and cardiac color Doppler ultrasound results left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS), left ventricular end-diastolic diameter (LVDd) were compared, and the diagnostic value of serum Lp-PLA2, sLRP-1 and visfatin in patients with high risk of coronary heart disease was evaluated. The observation group was divided into remission group and non-remission group according to the outcome of enhanced external counterpulsation therapy, and the relationships of plasma Lp-PLA2, sLRP-1, visfatin with treatment outcomes were analyzed.

  Results  Plasma Lp-PLA2, sLRP-1 and visfatin levels in the observation group were significantly higher than those in the control group (P < 0.05). The plasma TC and TG levels in the experimental group were higher than those in the control group, while HDL-C level was lower than that of the control group (P < 0.05). The level of FS in experimental group was significantly higher than those in control group, LVDd was larger, while LVEF was significantly lower than that in the control group (P < 0.05). Receiver operating characteristic (ROC) curve results showed that the area under the curve (AUC) of plasma Lp-PLA2 in predicting the high risk of coronary heart disease was 0.669, and the optimal critical value was 47.36 μg/L. The AUC of serum sLRP-1 in predicting the high risk of coronary heart disease was 0.957, and the optimal critical value was 2.58 μg/mL. The AUC of serum visfatin in predicting the high risk of coronary heart disease was 0.932, and the optimal critical value was 53.46 ng/mL (P < 0.05). Plasma Lp-PLA2, sLRP-1 and visfatin levels in non-remission group were significantly higher than those in the remission group (P < 0.05). Logistic regression equation showed that plasma Lp-PLA2, sLRP-1 and visfatin were positively correlated with treatment outcomes (P < 0.05).

  Conclusion  Patients with higher plasma levels of Lp-PLA2, sLRP-1 and visfatin have poor response to enhanced external counterpulsation therapy.