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Objective To explore the predictive value of Tei index and plasma brain natriuretic peptide(BNP) on major adverse cardiovascular events(MACE) during long term follow up in the patients with anteriormyocardial infarction(MI).Methods A total of 238 patients with anterior MI were selected and divided into four groups according to the median of Tei index and BNP:G1 group(Tei≤0.66,BNP≤532.60 ng/mL,n=70),G2 group(Tei≤0.66,BNP＞532.60 ng/mL,n=51),G3 group(Tei＞0.66,BNP≤532.60 ng/mL,n=50) and G4 group(Tei＞0.66,BNP＞532.60 ng/mL,n=67).The follow up end was the MACE occurrence.Results There was a significant positive correlation between the Tei index and BNP(r=0.582,P=0.000).Tei entered the BNP regression equation(β=0.658,P＜0.05).The MACE-free survival rate had no statistical difference among 4 groups(x2 =9.975,P=0.019).The Cox regression analysis showed that Tei index and BNP were the independent predictive factors for MACE.Tei combined with BNP had stronger predictive value to MACE(AUC=0.781,95CI:0.721-0.841,P=0.000),its sensitivity was 72.52％ and specificity was 76.89％.Conclusion Tei combined with BNP has stronger predictive value for anterior MI during long term follow up.
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Objective: To study the relationship between insulin resistance (IR) and coronary collateral circulation in patients with impaired glucose tolerance (IGT). Methods: A total of 227 patients with coronary angiography (CAG) were studied. There were 131 patients with male gender and the average patient’s age was (53.2 ± 11.0) years. IR (HOMA2-IR) index was measured by HOMA2 method, the severity level of coronary stenosis was assessed by Gensini scoring system, collateral circulation condition was determined by Rentrop classiifcation. 187 IGT patients were divided into 4 groups: Rentrop 0 group,n=55, Rentrop 1 group,n=42, Rentrop 2 group,n=39 and Rentrop 3 group,n=51; in addition, Control group,n=40 patients with normal glucose tolerance and coronary stenosis<50%. Results: Compared with Control group, all patients in 4 Rentrop groups had increased 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while decreased fasting insulin (FINS), allP<0.05. Compared with Rentrop 3 group and Rentrop 2 group, the patients in Rentrop 1 group and Rentrop 0 group had elevated 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while Rentrop 0 group had reduced FINS, allP<0.05. Multivariable regression analysis showed that HOMA2-IR index (R=0.518,P<0.05), HbA1c (R=1.916, P<0.05), 2h-PBG (R=2.130,P<0.05) and FINS (R=1.547,P<0.05) might be related to the severity of coronary stenosis. Binary regression analysis indicated that poor collateral circulation (the patients in Rentrop 0 group and Rentrop 1 group) was related to HOMA2-IR index (OR=1.679, 95% CI 1.101-2.558,P=0.016). Conclusion: HOMA2-IR index could be signiifcantly higher in patients with IGT combining chronic coronary occlusion. IR was the independent risk factor for the severity of coronary stenosis and coronary collateral formation.
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Objective To investigate the effects of 10 mg and 20 mg atorvastatin and 10 mg rosuvastatin on inflammatory factors in patients with acute coronary syndrome (ACS).Methods 66 patients with ACS were randomly divided into three groups:the 10 mg atorvastatin group,the 20 mg atorvastatin group and the 10 mg rosuvastatin group(n=22 for each group).The levels of blood lipids,serum matrix metalloproteinases-9 (MMP-9)and plasminogen activator inhibitor-1 (PAI-1)were measured before and after two-week treatment.19 patients with normal coronary angiography were assigned to the control group.Results The concentration of serum MMP-9 and PAI-1 was higher significantly in patients with ACS than those in control subjects(P＜0.05 or P＜0.01).After two weeks'treatment,the serum MMP-9 and PAI-1 levels were lowered significantly (P＜0.01),which were much better in groups of 20mg atorvastatin and of 10mg rosuvastatin than those in group of 10mg atorvastatin (P＜0.05 or P＜0.01 ).No relationship was observed between the levels of above inflammatory markers and serum hpids levels(P＞0.05).Conclusion 10 mg Rosuvastatin can greatly reduce the serum level of MMP-9 and PAI-1 as compared to 10 mg atorvastatin in patients with ACS ,equivalent to the effect of 20 mg atorvastatin,suggesting that the anti-inflammatory effect is independent of lipid-lowering action.
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Objective To investigate the correlation between the olasma concentrations of angiotesin Ⅱ,aldosterone and the parameters that reflected the reconstruction of left ventricular in chronic heart failur(CHF)patients.Methods 61 CHF pmiems and 20 normal control subjects were enrolled.plasma concentration of angiotesin Ⅱ,aldosterone were measured by specific radioimmunoassays.Two dimensional,M-mode and Doppler ultrasound recording were obtalned to determine left vantricular mass index(LVMI),left ventricular ejection fraction(LVEF)and maximal early transmitral flow velocity in diastole(VE)and maximal late transmittal flow velocity(VA).Results Baseline plasma concemrations of angiotesin Ⅱ,aldostemne were increased significantly in CHF patients as compared with normal thme of control group and were paralleled to the increase of NYHA cardiac functional classification of CHF(P＜0.01).Plasma concentrations of angiotesin Ⅱ,aldostemne were positively correlated with LVMI but negatively correlated with VE/VA(P＜0.01).Conclusion Plasma concentrations of angiotesin Ⅱ,aldosterone were increased signifcantly in CHF patients and might be involved in and regulated the reconstruction of left ventricular in CHF patients.
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Objective To explore the difference of plasma pentraxin 3 (PTX3) levels in acute coronary syndrome (ACS) patients,and to evaluate the correlation between plasma PTX3 levels and ACS as well as hypersensitive C-reaction protein (hs-CRP), through detecting the plasma levels of PTX3 and serum levels of hs-CRP in ACS patients, stable angina pectoris (SAP) patients and normal controls. Methods According to coronary angiography results,78 subjects were divided into control group (n = 20), stable angina pectoris (SAP) group (n = 22), and acute coronary syndrome (ACS) group (n = 36). The plasma levels of PTX3 and serum hs-CRP as well as routine blood biochemical markers were detected on the second day after admission. SPSS10.0 was used for one-factor analysis of variance and Logistic regression analysis. Results The logarithm level of plasma PTX3 in ACS group was significantly higher than that of the other two groups (P <0.05). The difference between the SAP group and the control group was not statistically significant (P > 0.05). Logistic regression analysis revealed that the estimated value of the plasma PTX3 logarithm level was 2.32 (P < 0.05), that of the serum hs-CRP was 0.447 (P > 0.05). Conclusion The plasma PTX3 level in ACS group is significantly higher than that of the SAP group and the control group. The correlation between plasma FTX3 levels and the ACS is stronger than that of the serum hs-CRP levels.