Correlation of Serum Adropin,Toll-Like Receptor 4,and GMP-140 Levels with the Severity of Coronary Artery Lesions in Patients with Unstable Angina Pectoris and Their Prognostic Value

ZHANG Honglei; CHEN Songyang

doi:10.3969/j.issn.1004-437X.2025.15.019

Abstract：Objective To analyze the correlation between serum recombinant protein adropin,Toll-like receptor 4 and plateletα-granular membrane protein-140(GMP-140)and the degree of coronary artery lesions in patients with unstable angina pectoris(UAP),and to explore the predictive value of changes in their levels for the prognosis of patients with UAP.Methods A retrospective study was conducted on 90 UAP patients admitted to Luohe Central Hospital from June 2021 to June 2023,serving as the study group.Meanwhile,90 patients with stable angina pectoris during the same period served as the control group.Additionally,45 healthy volunteers during the same period were selected as the healthy control group.The serum levels of adropin,Toll-like receptor 4,GMP-140 and cardiac function[B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),stroke volume(SV),left ventricular end-diastolic diameter(LVEDD),QT interval dispersion(QTd)]in 3 groups were compared.According to the degree of coronary artery disease,the patients were divided into mild 29 cases,moderate 35 cases and severe 26 cases.According to the number of coronary artery lesions,the patients were divided into 22 cases with single artery disease,41 cases with double artery disease and 27 cases with multiple artery disease.The serum levels of adropin,Toll-like receptor 4 and GMP-140 were compared.The correlation of serum levels of adropin,Toll-like receptor 4 and GMP-140 with cardiac function,degree of coronary artery disease and number of coronary artery disease were analyzed.The study group was treated with conventional regimens such as drugs and percutaneous coronary intervention,and was categorized into 24 cases with a poor prognosis and 66 cases with a good prognosis based on the prognosis at 6 months after treatment.The serum levels of adropin,Toll-like receptor 4 and GMP-140 were compared,and the predictive value of each serum index level for poor prognosis 2 months after treatment was analyzed.The net reclassification index and comprehensive discriminant improvement index were used to analyze the improvement of different prediction schemes in predicting poor prognosis.Results Serum adropin levels,LVEF,SV＜control group＜healthy control group,serum Toll-like receptor 4,GMP-140,BNP levels,LVEDD,QTd＞control group＞healthy control group(P＜0.05).With the severity of coronary lesions and the number of coronary lesions increasing,serum adropin level decreased,and serum Toll-like receptor 4 and GMP-140 levels increased(P＜0.05).Toll-like receptor 4 and GMP-140 were positively correlated with BNP,the severity of coronary artery disease,and the number of diseased coronary artery branches,while negatively correlated with LVEF,However,adropin exhibits the opposite trend(P＜0.05).Patients with poor prognosis had lower serum adropin levels and higher levels of TLR4 and GMP-140 two months after treatment than those with good prognosis(P＜0.05).The area under the curve(AUC)of serum adropin,Toll-like receptor 4 and GMP-140 combined to predict poor prognosis was greater than that of single index,and the combined detection significantly improved the predictive efficacy of poor prognosis(P＜0.05).Conclusion Serum levels of adropin,Toll-like receptor 4 and GMP-140 are closely related to the degree of coronary lesions in UAP patients,and the combined detection of their levels is better in predicting prognosis.