Abstract: Objective To explore the levels and clinical value of serum semaphorin 7A (Sema7A) in the patients with acute coronary syndrome (ACS). Methods A total of 94 elderly patients with new onset of ACS who underwent coronary angiography from January 2020 to October 2023 in Fengyang County People’s Hospital were enrolled in ACS group, and 94 elderly patients with chronic coronary syndrome (CCS) undergoing coronary angiography at the same period were enrolled as control (CCS group). The level of serum Sema7A was evaluated by ELISA.The correlation between serum Sema7A level and the levels of interleukin-1β(IL-1β), IL-6, tumor necrosis factor-α (TNF-α) and IL-10 was analyzed.The level of serum Sema7A was compared between the two groups and its clinical significance was analyzed. Results The level of serum Sema7A was significantly higher in ACS group than that in CCS group (12.09±8.57 vs 8.65±6.57 ng/mL, P<0.01). According to Gensini score, the patients in ACS group were divided into mild disease group, moderate disease group and severe disease group.The level of serum Sema7A in severe disease group was significantly higher than that in moderate disease group and mild disease group(P<0.01).The level of serum Sema7A in ACS group was significantly correlated with the levels of IL-1β, IL-6, TNF-α and IL-10 (P<0.01). ROC curve analysis showed that the optimal cut-off value of serum Sema7A to predict ACS was 6.13 ng/mL with a sensitivity of 72.6%, a specificity of 78.3% and the area under curve (AUC) of 0.653 (95%CI:0.585-0.722, P<0.01). Conclusions Serum Sema7A level is significantly correlated with the severity of coronary artery stenosis in the elderly patients with ACS, and it may be a potential biomarker for predicting ACS.

Key words: aged, acute coronary syndrome, semaphorin 7A, biomarker, coronary atherosclerotic plaque, vulnerable plaque