Abstract
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.