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OBJECTIVE@#To explore the correlation of plasma N-acetyl-neuraminic acid level with Thrombolysis In Myocardial Infarction (TIMI) risk score and clinical outcomes of patients with acute coronary syndrome (ACS).@*METHODS@#We consecutively enrolled 708 consecutive patients (401 male and 307 female, mean age 63.6±10.6 years) undergoing coronary angiography in our hospital between October, 2018 and July, 2019, including 597 patients with ACS and 111 without ACS (control group). The patients with ACS group were divided into high (=104), moderate (=425) and low (=68) risk groups according to their TIMI risk scores. All the participants were examined for plasma Neu5Ac level using liquid chromatography-tandem mass spectrometry and underwent coronary angiography with their Gensini scores calculated. The patients with ACS were followed up after discharge for a mean of 15 months for the occurrence of major adverse cardiac events (Mace). Binary logistic regression analysis was performed to identify the risk factors of Mace in these patients.@*RESULTS@#Plasma Neu5Ac levels were significantly higher in ACS group than in the control group ( < 0.05). ROC curve analysis showed that plasma Neu5Ac level could assist in the diagnosis of ACS (0.648 [0.597-0.699]) with a sensitivity of 39.2% and a specificity of 86.5% at the cutoff value of 288.50 ng/mL. In the ACS patients, plasma Neu5Ac level was significantly higher in the high-risk group than in the moderate-risk and low-risk groups ( < 0.05) and could assist in the diagnosis of a high risk (0.645 [0.588-0.703]) with a sensitivity of 42.3% and a specificity of 80.1% at the cutoff value of 327.50 ng/ mL. Plasma Neu5Ac was positively correlated with age, serum uric acid, creatinine, lipoprotein a, Ddimer, C-reactive protein, MB isoform of creatine kinase and Gensini score and negatively correlated with high-density lipoprotein level. During the followup, 80 ACS patients experienced Mace, who had significantly higher plasma Neu5Ac level than those without Mace (=517). Logistic regression analysis showed that plasma Neu5Ac level and a history of previous stroke were independent risk factors for the occurrence of Mace.@*CONCLUSIONS@#Plasma Neu5Ac level can provide assistance in the diagnosis and risk stratification of ACS and is an independent risk factor for prognosis of ACS patients.
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Objective To assess the relationship of CYP2C19 gene polymorphism with clopidogrel respon-siveness and the level of EETs in patients with ACS. Methods A total of 123 patients with ACS receiving aspirin combined with clopidogrel dual antiplatelet were enrolled. According to the results of CYP2C19 genotype,patients were divided into three groups:fast metabolic type ,medium metabolic type ,and slow metabolism type. The concentration of EETs and PAIR were compared between three groups. Logistic analysis was used to analyze the risk factors of LCR. Results There were differences statistically in level of EETs and PAIR among the three groups(P<0.05). Logistic analysis showed that the slow metabolism of CYP2C19 gene and lower EETs level were risk factors for LCR. The area under the ROC curve was 0.893(P < 0.05)by EETs level to predict the CYP2C19 genotype. Conclusion The slow metabolism of CYP2C19 gene was an independent risk factor for LCR,while the increase of plasma EETs level was a protective factor.
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Objective: To explore the endothelial microparticle (EMP) level in elderly patients with acute coronary syndrome (ACS) combining diabetic mellitus (DM)) and to study the relationship between EMP level and ACS combining DM in elder patients. Methods: A total of 208 patients≥65 years with coronary angiography in our hospital were summarized including 124 male with the age of (71.9 ± 5.2) years. The patients were divided into 3 groups, Control group, n=51 normal subjects, ACS without DM group, n=83 and ACS+DM group, n=74. Plasma EMP levels were measured by FACSCalibur lfow cytometry as CD31+/CD42b-EMPS and the vascular stenosis degree was quantitatively calculated with Gensini score. Results: The CD31+/CD42b-EMPs level in ACS + DM group >ACS without DM group > Control group, all P Conclusion: Plasma CD31+/CD42b-EMPs level increased in elderly ACS patients and the elevation level related to vascular lesion degree/combining with DM, which indicated the endothelial dysfunction in such patients.
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<p><b>OBJECTIVE</b>To investigate the correlation of G487A polymorphism of aldehyde dehydrogenase-2 (ALDH2) gene with hypertension in patients with coronary heart disease complicated by type 2 diabetes.</p><p><b>METHODS</b>This study was conducted among 167 patients with coronary heart disease complicated by diabetes mellitus. The polymorphisms of gene G487A ALDH2 were determined using polymerase chain reaction-restricted fragments length polymorphism technique (PCR-RFLP). According to the genotypes, the patients were divided into GG group (n=105) and GA/AA group (n=62), and the incidence of hypertension, risk factors of hypertension, systolic and diastolic pressures, and pulse pressure indexes were compared between the two groups. Multivariate logistic regression analysis was performed to adjust the effects of the confounding factors.</p><p><b>RESULTS</b>The incidence of hypertension in GA/AA group was significantly higher than that in GG group (P<0.05), and the former group showed a significantly greater differences between systolic and pulse pressure; the diastolic pressure was comparable between the two groups. Multivariate logistic regression analysis showed that GA/AA was associated with an increased risk of hypertension in synergy with high insulin level and insulin resistance.</p><p><b>CONCLUSION</b>ALDH2 gene G487A polymorphism may be associated with hypertension in patients with coronary heart disease complicated by type 2 diabetes, and the patients with an A allele have a greater risk of developing hypertension.</p>