Predictive Potential of CRTP5 and SII for Coronary Artery Severity and Myocardial Fibrosis in Patients with NSTE-ACS: An Exploratory Biomarker Study.

PURPOSE: Findings from this research aim to enhance clinical assessments of coronary artery disease severity and myocardial fibrosis (MF).

METHODS

A total of 523 eligible non-ST-segment elevation acute coronary syndromes (NSTE-ACS) patients were included. Clinical data were collected and analyzed. Multifactorial logistic regression analysis was applied to identify factors influencing coronary artery lesions in patients with NSTE-ACS. Diagnostic accuracy for Complement C1q tumor necrosis factor-related protein 5 (CTRP5) and systemic immune-inflammation index (SII) in assessing coronary artery lesions and MF was analyzed via receiver operating characteristic (ROC) curve analysis.

RESULTS

The levels of CTRP5 and SII were significantly different between the unstable angina pectoris (UAP) and ST-segment elevation myocardial infarction (NSTEMI) groups (all P<0.05). Significant differences in CTRP5, SII, PCI, and PCIII were noted across the Single-, Two-, and Three-vessel lesion groups (all P<0.05). Multifactorial logistic regression analysis revealed that CTRP5 (odds ratio [OR], 1.621; 95% confidence interval [CI], 1.103-1.984; P<0.001) and SII (OR, 1.473; 95% CI, 1.178-1.840; P<0.001) were independent risk factors for three-vessel lesions. The ROC curve analysis demonstrated that CTRP5 and SII effectively predicted three-vessel lesions, with area under curve (AUC) values of 0.823 [cut-off value13.99; 95% confidence interval (CI), 0.779-0.866, P<0.001] and 0.796 [cut-off value, 837.5; 95% CI, 0.747-0.845, P<0.001], respectively. The ROC curve analysis evaluated the ability of CTRP5 and SII to predict MF; AUC values were 0.809 (cut-off value, 11.95; 95% CI, 0.724-0.895, P<0.001) and 0.713 (cut-off value, 624.2; 95% CI, 0.611-0.815, P<0.001), respectively.

CONCLUSION

CTRP5 and SII demonstrate strong potential as early diagnostic markers for assessing the severity of coronary artery disease and MF in patients with NSTE-ACS.