Hypersensitive C-reactive Protein to HDL-C Ratio Predicts the Severity of Coronary Artery Disease

Abstract

Background: Lipid and inflammatory molecules play a key role in the development of coronary atherosclerosis. Hypersensitive C-reactive proteins are used as markers of inflammation duration, and HDL-C is used as an anti-atherosclerosis component. However, few studies have combined the two indicators to explore coronary stenosis. We suggested that Hypersensitive C-reactive proteins as a marker of inflammation persistence and HDL-C as an anti-atherosclerosis component should be integrated into a single biomarker , so as to explore the correlation of Hypersensitive C-reactive protein HDL-C ratio with the severity of coronary stenosis and to predict the severity of coronary stenosis in CAD patients.Methods: We examined 360 eligible patients who underwent coronary angiography. Based on the results of coronary angiography, patients with any major coronary arteries (the left anterior descending artery, the left circumflex artery, the left main coronary artery, the right coronary artery) whose lumen diameter reduced by more than 50% were defined as CAD + group (n = 139) .Patients with luminal stenosis but no more than 50% were defined as CAD- group (n = 41), and patients without luminal stenosis (n = 180) were regarded as control group. The relationship between various serum markers and the severity of coronary stenosis was examined by Spearman correlation analysis. Logistic regression analysis was performed to identify the influencing factors of the severity of coronary artery disease.Results: The modified Gensini score was positively correlated with Hypersensitive C-reactive protein HDL-C ratio . Multiple regression analysis showed that Hypersensitive C-reactive protein HDL-C ratio were significantly associated with CAD. Hypersensitive C-reactive protein HDL-C ratio is an independent predictor of CAD. The ROC analysis provided a cut-off value of 1.17 for Hypersensitive C-reactive protein HDL-C ratio to predict CAD with 83.9% specificity and 0.242 Yoden index, and area under the ROC curve of 0.632 (95%CI 0.571-0.694, P <0.001).At the same time, the area under the ROC curve of Neutrophil HDL-C ratio was 0.620, indicating that Hypersensitive C-reactive protein HDL-C ratio as a predictor of CAD has better diagnostic performance than Neutrophil HDL-C ratio.Conclusion: Hypersensitive C-reactive protein HDL-C ratio is not only closely related to coronary artery stenosis, but also an independent predictor of severe coronary stenosis.