ABSTRACT
BACKGROUND: The triglyceride-glucose (TyG) index was shown to be an independent predictor of coronary artery disease (CAD) progression and prognosis. However, whether the TyG index can predict the severity of CAD in nondiabetic patients with chronic coronary syndrome (CCS) remains unclear. METHODS: A total of 118 individuals who underwent elective coronary angiography (CA) were classified into group A (59 with coronary lesions) and group B (59 with normal coronary arteries; as a control group) after CA, laboratory tests for fasting and the postprandial (PP) TyG index. The complexity of CAD was determined by the SYNTAX score (SYNTAX score > 22 indicated moderate-high risk), and patients diagnosed diabetes or prediabetes were excluded. RESULTS: The TyG index was not related to the SYNTAX score in groups A and B; however, in the CAD group with an LDL concentration <70 mg/dl (group A1), a fasting TyG index ≥ 8.25 and a PP TyG index ≥ 11 could predict moderate-high SYNTAX risk score; in addition, the odds ratio was 4.3 times higher, and the relative risk was 1.8 times greater (OR=4.3, RR=1.8, 95% CI=1.4-13.5 p<0.05) for individuals with a higher fasting TyG index ≥8.25 to have a moderate-high SYNTAX risk score. Individuals with a higher PP TyG index ≥11 had odds ratio of 2.6 times higher and a relative risk of 1.4 times greater to have moderate-high SYNTAX risk score. CONCLUSIONS: Both fasting and postprandial TyG levels were associated with greater coronary anatomical complexity (SYNTAX score > 22) in nondiabetic chronic coronary patients with LDL <70 mg/dL. Fasting and the postprandial TyG indices can serve as noninvasive predictors of CAD complexity in nondiabetic patients with LDL <70 mg/dl and could change the management and therapeutic approach.
ABSTRACT
Hypertension is a serious medical condition that can increase the risk of developing heart, brain, kidney, and other diseases. Many asymptomatic hypertension patients experience asymptomatic organ damage (AOD). The purpose of this study was to determine the roles of LncRNA-GAS5 and ß-catenin in predicting AOD in hypertensive nondiabetic patients. This study included 256 subjects, 128 hypertension patients (75 of whom had AOD, and 53 of whom did not) and 128 healthy controls. qRT-PCR was used to assess LncRNA-GAS5, and ELISA was used to assess ß-catenin. The LncRNA-GAS5 expression level was decreased in hypertensive patients compared to controls (p-value < 0.001). On the other hand, ß-catenin levels showed higher levels in the patients in comparison with controls (p-value < 0.001). A 0.38-fold change in LncRNA-GAS5 expression predicted AOD with 86.6% sensitivity and 88.7% specificity. ß-Catenin > 80.5 pg/mL predicted AOD with a sensitivity of 82.6% and specificity of 69.8%. LncRNA-GAS5 expression was a better diagnostic predictor of AOD than ß-catenin. According to multivariate logistic regression analysis, decreased LncRNA-GAS5 expression independently increased the risk of AOD (adjusted odds ratio = 0.03 (95% CI: 0.01-0.1) (p < 0.001). Furthermore, elevated ß-catenin levels may be an independent risk factor for AOD (adjusted odds ratio = 14.3 (95% confidence interval, 3.3-61.9) (p < 0.001). Collectively, in hypertensive patients, LncRNA GAS5 and ß-catenin can distinguish patients with AOD from those who do not have AOD. LncRNA GAS5 and ß-catenin can be used as independent predictors of AOD in hypertensive patients.
ABSTRACT
BACKGROUND: For cardiologists, management of acute chest pain continues to be a challenge. Physicians struggle to avoid unnecessary admissions and at the same time not to miss high-risk patients needing urgent intervention. Therefore, diagnostic strategies focus on identifying patients in whom an acute coronary syndrome can be safely ruled out based on findings from history, physical examination, and early cardiac marker measurement. The HEART score, a clinical prediction rule, was developed to provide the clinician with a simple and reliable predictor of cardiac risk. AIM: This study aimed to investigate the role of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) as independent laboratory biomarkers when associated with the HEART risk score. METHOD: A cross-sectional study of 120 patients who attended the emergency department with acute chest pain. NLR and PLR were both measured. In addition, the HEART score was the valid instrument used in evaluating and risk stratifying patients into low-, intermediate-, and high-risk group. RESULTS: There was a positive correlation between the HEART score and the mean PLR and NLR (p = 0.000*). PLR and NLR were found to be significantly higher in the high-risk HEART score group (p = 0.05 and 0.0001*, respectively). A PLR of 115.5 and above had a sensitivity of 73% and specificity of 78%, while an NLR of 3.95 and above had a sensitivity of 75% and specificity of 86% to detect high-risk HEART score patients. CONCLUSION: PLR and NLR proved to be a useful tool to identify high-risk patients when validated against the HEART score.
