Objective:To analyze the relationship between serum complement C1q/tumor necrosis factor-relat-ed protein 5(CTRP5)level and the severity of coronary artery disease and myocardial fibrosis in patients with a-cute coronary syndrome(ACS).Methods:A total of 210 patients with ACS hospitalized in the Department of Car-diology,Hengshui People's Hospital from October 2022 to October 2023 were selected.All patients were divided into the unstable angina pectoris(UA)subgroup,the non ST-segment elevation myocardial infarction(NSTEMI)subgroup,and the ST-segment elevation myocardial infarction(STEMI)subgroup according to clinical diagnostic criteria.Patients were divided into the single-vessel disease subgroup,double-vessel disease subgroup,and three-vessel disease subgroup based on the number of coronary artery lesions.Patients were divided into the high-score subgroup(＞60 points),middle-score subgroup(31-60 points),and low-score subgroup(0-30 points)according to gensini score.Sixty ACS patients underwent cardiac magnetic resonance examination one month after opera-tion,and were divided into the LGE positive group and LGE negative group according to cardiovascular magnetic resonance-delayed gadolinium enhancement(CMR-LGE).Another 100 patients without obvious obstructive steno-sis by coronary angiography were selected as the control group.The systemic immune inflammation index(SII)and serum CTRP5 levels were compared among the groups.Logistic regression analysis was used to analyze the factors affecting the degree of coronary artery disease.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum CTRP5 on the degree of coronary artery disease and myocardial fi-brosis.Results:The levels of serum CTRP5 and SII in the UA subgroup,NSTEMI subgroup,and STEMI group were higher than those in the control group(all P＜0.05),but there was no significant difference in CTRP5 and SII levels between the NSTEMI subgroup and the STEMI subgroup.With the increase of coronary artery lesions and Gensini score,CTRP5 and SII levels showed an increasing trend(both P＜0.05).CTRP5 and SII levels in the LGE positive group were higher than those in the LGE negative group(both P＜0.05).Logistic regression analy-sis showed that fasting blood glucose(FBG,OR=1.267,95％CI:1.041-1.544,P=0.019),SII(OR=1.001,95％CI:1.000-1002,P=0.044),and CTRP5(OR=1.127,95％CI:1.036-1.226,P=0.005)were risk factors affecting the severity of coronary artery disease.ROC analysis showed that the area under the curve(AUC)of CTRP5 in predicting multi-vessel disease was 0.708,the sensitivity was 81.4％,the specificity was 78.9％,and the cut-off value was 10.31 ng/mL.The AUC of CTRP5 in predicting myocardial fibrosis was 0.775,the sensitivity was 64.7％,the specificity was 92.3％,and the cut-off value was 11.10 ng/mL.Conclusion:The level of serum CTRP5 in ACS patients is increased and its level has a good predictive value for the degree of coronary artery disease especially for multivessel disease and myocardial fibrosis.
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