ABSTRACT
Objective To investigate the clinical prediction value of chemokine CCL21 level for acute coronary syndrome.Methods Totally 212 patients receiving coronary arteriography were divided into acute myocardial infarction group(AMI,n=72),unstable angina pectoris group(UAP,n=76),and stable angina pectoris group(SAP,n=64).The serum level of chemokine CCL21 was detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA)and the pathological changes of coronary artery were measured by Gensini scoring system.All patients were followed up for six months and the cardiovascular adverse events were recorded.Results The serum level of CCL21 was(169.72±14.64)ng/L in AMI group,(154.42±16.50)ng/L in UAP group,and(143.87±9.80) ng/L in SAP group,with statistically significant differences (F =99.818,P =0.000).Serum levels of CCL21 in ACS group and SAP group were positively correlated with Gensini score(r=0.474,P =0.000;r=0.350,P=0.049).Binary Logistic regression analysis revealed that chemokine CCL21 was an independent risk factor for predicting acute coronary syndrome (OR =1.049,P =0.022).The CCL21-judged area under the ROC curve in acute coronary syndrome group was 0.887 ± 0.028 (P =0.000),with diagnostic point of serum level of chemokine CCL21 at 159.15 ng/L,sensitivity of 0.635,specificity of 0.981.Serum level of CCL21 was higher in the patients with cardiovascular adverse events than in the patients without cardiovascular adverse events[(168.57±7.24)ng/L vs.(156.92± 6.53) ng/L],with statistically significant difference (t =16.100,P =0.000).Conclusions Serum level of chemokine CCL21 reflects the severity degree of coronary artery disease.The chemokine CCL21,as an independent and effective marker,can predict acute coronary syndrome.
ABSTRACT
Objective To assess the prevalence and risk factors associated with clopidogrel resistance in patients with acute myocardial infarction after primary PCI(percutaneous coronary intervention). Methods Using a retrospective case?control study,210 patients with acute myocardial in?farction who underwent primary PCI in the first hospital affiliated to China Medical University between October 2013 and September 2014 were re?viewed. Patients were divided into the normal group and the resistance group according to the platelet aggregation rate(PAR),and the incidence of clopidogrel resistance was calculated and the correlation between age,gender,smoking,alcohol drinking,blood pressure,blood lipid,glycosylated hemoglobin,and the clopidogrel resistance were analyzed. Results The incidence of clopidogrel resistance in patients underwent primary PCI was 36.67%. Platelet aggregation rates were 62.62 ± 9.23%and 32.71 ± 11.77%respectively in two groups(P<0.001). Multivariate logistic regression analysis found that clopidogrel resistance was positively correlated to high level of glycosylated hemoglobin(P=0.037,OR 1.241,95%CI 1.013?1.519). Conclusion High level of glycosylated hemoglobin was the independent risk factor of clopidogrel resistance. The risk of clopidogrel resis?tance will significantly increase in these diabetic patients who cannot control blood sugar well.