Key result
A combined model of diabetes, MHR, SII, TNF-α, ANGPTL3, and ANGPTL4 demonstrates ~0.92 AUC for CAD.
Why the study?
The study was conducted to investigate the relationship between coronary artery disease (CAD), systemic inflammation indices, and lipid metabolism-related factors, and to discuss their clinical application in CAD.
Do systemic inflammation indices and lipid metabolism-related factors predict the presence of coronary artery disease in inpatients with suspected CAD?
Observational (n=284)
Do systemic inflammation indices and lipid metabolism-related factors predict the presence of coronary artery disease in inpatients with suspected CAD?
Effect estimate: AUC 0.921 (95% CI 0.881-0.960)
p-value: p=< 0.001
Systemic inflammation indices and lipid metabolism-related factors, particularly when combined with diabetes, demonstrate high diagnostic accuracy for identifying coronary artery disease.
Hypothesis-generating for multi-marker CAD diagnosis in inpatients; prospective validation required before any practice change.
OBJECTIVE: We aimed to investigate the relationship between coronary artery disease (CAD) and systemic inflammation indices and lipid metabolism-related factors and subsequently, discuss the clinical application of these factors in CAD. METHODS: We enrolled 284 consecutive inpatients with suspected CAD and divided them into a CAD group and a non-CAD group according to coronary angiography results. Serum levels of angiopoietin-like protein 3 (ANGPTL3), angiopoietin-like protein 4 (ANGPTL4), fatty acid-binding protein 4 (FABP4), and tumor necrosis factor-α (TNF-α) levels were assessed using the ELISA and the systemic inflammation indices were calculated. Multivariate logistic regression was used to assess the risk factors of CAD. The receiver operating characteristic curve was used to determine the cutoff and diagnostic values. RESULTS: The neutrophil-to-high density lipoprotein cholesterol ratio (5.04 vs. 3.47), neutrophil-to-lymphocyte ratio (3.25 vs. 2.45), monocyte-to-high density lipoprotein cholesterol ratio (MHR) (0.46 vs. 0.36), monocyte-to-lymphocyte ratio (0.31 vs. 0.26), systemic immune-inflammation index (SII) (696.00 vs. 544.82), serum TNF-α (398.15 ng/l vs. 350.65 ng/l), FABP4 (1644.00 ng/l vs. 1553.00 ng/l), ANGPTL3 (57.60 ng/ml vs. 52.85 ng/ml), and ANGPTL4 (37.35 ng/ml vs. 35.20 ng/ml) values showed a significant difference between the CAD and non-CAD groups ( P < 0.05). After adjusting for confounding factors, the following values were obtained: ANGPTL3 > 67.53 ng/ml [odds ratio (OR) = 8.108, 95% confidence interval (CI) (1.022-65.620)]; ANGPTL4 > 29.95 ng/ml [OR = 5.599, 95% CI (1.809-17.334)]; MHR > 0.47 [OR = 4.872, 95% CI (1.715-13.835)]; SII > 589.12 [OR = 5.131, 95% CI (1.995-13.200)]. These factors were found to be independently associated with CAD ( P < 0.05). Diabetes combined with MHR > 0.47, SII > 589.12, TNF-α >285.60 ng/l, ANGPTL3 > 67.53 ng/ml, and ANGPTL4 > 29.95 ng/l had the highest diagnostic value for CAD [area under the curve: 0.921, 95% CI, (0.881-0.960), Sensitivity: 88.9%, Specificity: 82.2%, P < 0.001]. CONCLUSION: MHR > 0.47, SII > 589.12, TNF-α >285.60 ng/l, ANGPTL3 > 67.53 ng/ml, and ANGPTL4 > 29.95 ng/l were identified as independent CAD risk factors and have valuable clinical implications in the diagnosis and treatment of CAD.
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Zhao et al. (2023) conducted an observational in Coronary artery disease (n=284). Systemic inflammation indices and lipid metabolism-related factors vs. Non-CAD group was evaluated on Diagnostic value for CAD using a combined model (AUC 0.921, 95% CI 0.881-0.960, p=< 0.001). A combination of diabetes, MHR >0.47, SII >589.12, TNF-α >285.60 ng/l, ANGPTL3 >67.53 ng/ml, and ANGPTL4 >29.95 ng/l demonstrated high diagnostic value for CAD (AUC 0.921; 95% CI 0.881-0.960; P<0.001).
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