Disscussion on influencing factors of coronary artery disease in elderly patients with coronary atherosclerotic heart disease

Objective To study the effects of circulation human angiotensin 1-7 (Ang1-7)、CD31+ 、CD14+ CD16+ and hypersensitive C-reactive protein(hs-CRP) on coronary artery lesions in elderly patients with coronary artery disease. Methods One hundred and forty elderly patients with coronary artery disease were enrolled during the time period from January 2010 to March 2014 , 50 healthy persons were selected as the control group. According to the degree of coronary artery stenosis, the patients were divided into 3 groups: 75% to 84% group, 85% to 94% group and 95% to 100% group. According to the number of diseased coronary arteries, the patients were divided into 4 groups: single vessel lesion group, double vessel lesion group, three branch lesion group and four vessel disease group. According to the New York Heart Association (NYHA) classification, the patients were divided into 4 groups: NYHA Ⅰ group, NYHA Ⅱ group, NYHA Ⅲ group and NYHA Ⅳ group. According to the left ventricular ejection fraction (LVEF), the patients were divided into 3 groups: 48% to 58% group, 36% to 47% group and 25% to 35% group. According to the six-minute-walking-test, the patients were divided into 3 groups: >450 m group, 150-450 m group and<150 m group. Flow cytometry were used to detect the changes of serum CD31+ and CD14+ CD16+ levels. Double antibody sandwich enzyme-linked immunosorbent assay was used to quantitatively detect the levels of Ang1-7.The levels of hs-CRP were measured by immune scatter turbidity method. Multi group differences were analyzed by single factor analysis of variance, and t test was used to compare between the two groups. Results Patients with coronary artery stenosis showed Ang1-7(34.8±6.9)pg/mL, CD31+ (471±29)/μL, CD14+ CD16+ (1.4±0.3)%, hs-CRP(1.7±0.8)mg/L in 75%-84% group vs Ang1-7 (9.1±0.4)pg/mL, CD31+ (1554±40)/μL, CD14+ CD16+ (5.9±0.8)%, hs-CRP (7.1±1.5)mg/L in 95%-100%group, the differences were statistically significant, all P values were less than 0.05. Ang1-7(38.7±7.9)pg/mL, CD31+ (496±30)/μL, CD14+ CD16+ (2.1±0.7)%, hs-CRP(1.9±0.9)mg/L in single vessel lesion group vs Ang1-7(11.2±2.0)pg/mL, CD31+ (1583±52)/μL, CD14+ CD16+ (10.6±1.4)%, hs-CRP(14.9±1.9)mg/L in four vessel disease group, the differences were statistically significant, all P values were less than 0.05. NYHAⅠ group Ang1-7(38.5±2.7)pg/mL、CD31+ (511±32)/μL、CD14+ CD16+ (1.7±0.5)%、hs-CRP(1.9±0.2)mg/L vs NYHA Ⅳgroup Ang1-7(10.0±1.2)pg/mL、CD31+ (1598±49)/μL、CD14+ CD16+ (12.1±1.4)%、hs-CRP(15.0±1.9)mg/L, the differences were statistically significant, all P values were less than 0.05; LVEF 48%-58% group Ang1-7(32.9±6.8)pg/mL、CD31+ (385±28)/μL、CD14+ CD16+ (2.9±0.8)%、hs-CRP(2.1±0.8)mg/L vs LVEF 25%-35% group Ang1-7(9.5±2.0)pg/mL、CD31+ (1644±54)/μL、CD14+ CD16+ (13.0±1.6)%、hs-CRP(14.1±2.0)mg/L, the differences were statistically significant, all P values were less than 0.05; 6 min walk test Ang1-7(36.4±7.1)pg/mL、CD31+ (561±30)/μL、CD14+ CD16+ (1.9±0.5)%、hs-CRP(2.1±0.9)mg/L in >450 m group vs Ang1-7(10.1±0.9)pg/mL、CD31+ (1338±41)/μL、CD14+ CD16+ (7.2±0.9)%、hs-CRP(18.7±1.5)mg/L in <150 m group, the differences were statistically significant, all P values were less than 0.05. Conclusions The decrease in the level of Ang 1-7 and increase in the levels of CD31+ 、CD14+ CD16+ and hs-CRP maybe affect the degree of coronary artery stenosis in elderly patients with coronary artery disease. Key words: Coronary artery disease; Aged; Endothelial cells; Monocytes