Abstract: Objective To investigate the relationship between serum total bilirubin (TBIL), homocysteine (Hcy), hypersensitive C-reactive protein (hs-CRP), uric acid (UA) and unstable coronary plaque formation in the elderly patients with coronary heart disease (CHD). Methods A total of 198 patients with CHD admitted to our hospital from April 2019 to April 2021 were enrolled in the study, and they were divided into the unstable group (n=54) and the stable group (n=144). The baseline data and serum indexes of the two groups were compared, and multivariate Logistic regression analysis was used to clarify the risk factors of unstable coronary plaque formation in the elderly patients with CHD. Results The level of serum TBIL in the unstable group was significantly lower than that in the stable group(P<0.05). The levels of serum Hcy, hs-CRP and UA in the unstable group were significantly higher than those in the stable group (P<0.05). Receiver operating characterise curve analysis confirmed that serum TBIL, Hcy, hs-CRP and UA could be used to predict the formation of unstable coronary plaque in the elderly patients with CHD, with an AUC of 0.956, 0.647, 0.870 and 0.842, respectively (P<0.05). Multivariate Logistic regression analysis confirmed that serum TBIL≤7.985 μmol/L, Hcy≥12.725 μmol/L, hs-CRP ≥3.895 mg/L and UA≥340.645 μmol/L were the risk factors for coronary unstable plaque formation in the elderly patients with CHD (P<0.05). Conclusions The formation of unstable coronary plaque in the elderly patients with CHD is closely related to the expression of serum TBIL, Hcy, hs-CRP and UA. TBIL≤7.985 μmol/L, Hcy≥12.725 μmol/L, hs-CRP≥3.895 mg/L, UA≥340.645 μmol/L are the best cut-off values for predicting the formation of unstable coronary plaque.

Key words: coronary heart disease, aged, unstable coronary plaque, uric acid, total bilirubin, homocysteine, hypersensitive C-reactive protein