ABSTRACT
Objectives To study the predictive value of Toll-like receptors 3,4(TLR3,TLR4),fructosamine(FMN)and glycated hemoglobin A1c(HbA1c)in the in-stent restenosis and re-occlusion after primary percutaneous coronary intervention(PCI)in patients aged 70-85 years with old myocardial infarction.Methods 51 patients aged 70-85 years with in-stent restenosis after primary PCI from Jan 2007 to Sep 2016 were selected.Serum level changes in TLR3,TLR4 were detected by flow cytometry.The levels of FMN and HbA1c were tested by colorimetric endpoint reaction and high-pressure liquid chromatography respectively.Results The levels of TLR3,TLR4,FMN and HbA1c were gradually elevated along with the increases of artery numbers(0,1,2,>2)and percentage(0%,70-89%,90-99%,100%)of in-stent restenosis,LVEF(%)decrease and NYHA(Ⅰ,Ⅱ,Ⅲ,Ⅳ)increase(all P2)of in-stent restenosis in TLR3,and group of percentage(0%,70-89%,90-99%,100%)in the in-stent restenosis in TLR4,group of LVEF(%)in FMN,and group of NYHAⅠ,Ⅱ,Ⅲ,Ⅳ in HbA1c(%)(all P2)groups were(7.6±0.5),(18.9±0.6),(32.0±0.9),(51.3±0.8),respectively(all P<0.01).The levels of TLR4(%)in the in-stent restenosis percentage(0%,70-89%,90-99%,100%)groups were(10.5±7.0),(20.1±7.2),(33.3±9.7),(69.0±11.3%)respectively(all P<0.01).The levels of FMN(mmol/L)in LVEF[(49~59%),(37~48%),(25~36%)]groups were(0.6±0.4),(9.4±0.6),(18.1±0.8),respectively(all P<0.01).And the level of HbA1c(%)in groups of NYHA Ⅰ,NYHA Ⅱ,NYHA Ⅲ,NYHA Ⅳ were(6.1±0.4),(5.9±0.6),(8.9±0.9),(12.0±0.8),respectively(all P<0.01).Conclusions Serum level changes in TLR3,TLR4,FMN and HbA1c may become the new indicators to forecast the degree of in-stent restenosis in very old patients with old myocardial infarction after primary coronary intervention.
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Objective To study the changes in expression of high-sensitivity C-reactive protein (hsCRP),glutathione S-transferase Pi(GSTPi)and annexin A5 (AnxA5)in elderly patients with old myocardial infarction and the clinical significance.Methods Serum levels of GSTPi and AnxA5 were measured by ELISA and the level of hs-CRP was measured by immunoturbidimetry in elderly patients with old myocardial infarction (n =185)from December 2012 to November 2015.Results Along with the increasing coronary artery stenosis,GSTPi level was decreased and AnxA5/hs-CRP levels were increased in elderly patients with old myocardial infarction.In comparison between coronary artery stenosis ＞ 95％ group versus stenosis of 55％-65％ group,GSTPi was(190.0±37.0)μg/L vs.(289.0 ±86.0)μg/L,AnxA5 was(33.9±4.0)μg/L vs.(8.1 ± 2.9) μg/L,and hs-CRP was (15.3 ± 1.3) mg/L vs.(5.9 ± 0.8) mg/L with statistically significant differences(all P＜0.01).There were significant differences between LVEF 30％ group[GSTPi(198.0±39.0) μg/L,AnxA5(38.9±5.1)μg/L and hs-CRP(17.9± 1.9)mg/L]and LVEF 40％-54％ group[GSTPi(219.0± 61.0)μg/L,AnxA5 (12.9±3.9)μg/L and hs-CRP(10.1 ± 1.0) mg/L] (all P＜0.01).There were significant differences between NYHA Ⅳ group [GSTPi (171.0 ± 43.0) μg/L,AnxA5 (18.1 ± 5.0) μg/L and hs-CRP (16.9±2.1)mg/L]and NYHAⅠgroup[GSTPi(295.0±91.0)μg/L,AnxA5(7.3±3.1)μg/L and hs-CRP (7.8± 1.3)mg/L](all P＜0.01).Conclusions The expression of GSTPi,AnxA5 and hs-CRP in elderly patients with old myocardial infarction may become the new indicators to forecast the degrees of coronary artery stenosis and heart failure.
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Objective To explore the correlation of mimecan/osteoglycin withnuclear factor koppa B(NF-κB) and P53 in peripheral arterial disease (PAD) and PAD combined with type 2 diabetes in the elderly.Methods 120 patients with PAD and 60 healthy controls were enrolled in this study.PAD patients were divided into PAD group (n=60) and PAD combined with type 2 diabetes group (n =60) according to clinical diagnostic criteria.Patients in PAD group were divided into class Ⅰ (n=15),class Ⅱ (n=15),class Ⅲ (n=15) and class Ⅳ (n=15),and patients in PAD combined with type 2 diabetes group were divided to class Ⅰ (n=14),class Ⅱ (n=15),class Ⅲ (n=16) and class Ⅳ (n=15) according to Fontaine's classification.The levels of NF-κB,P53 and mimecan in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA).Results The levels of NF-κB,P53 and mimecan were significantly increased in PAD combined with type 2 diabetes group as compared with PAD and control groups [NF-κB..(32.8±5.3) mg/L vs.(19.8±4.2) mg/L,(26.3 ±4.8) mg/L; P53:(3.4±1.3) mg/Lvs.(2.5±1.1) mg/L,(1.4±0.8) mg/L; mimecan:(16.4 ±0.8) mg/L vs.(10.3±0.8) mg/L,(4.8±0.6) mg/L; all P＜0.05].There were significant differences in the levels of NF-κB,P53 and mimecan in class Ⅰ,class Ⅱ,class Ⅲ and class Ⅳ in PAD group [NF-κB:(20.3±3.1) mg/L,(24.5±3.4) mg/L,(28.2±4.6) mg/L and (34.2±5.3) mg/L; P53:(2.2 ±1.8) mg/L,(2.6±1.8) mg/L,(3.3±1.9) mg/L and (3.7±2.7) mg/L;mimecan (8.9±2.6) mg/L,(12.4±1.8) mg/L,(15.6±1.5) mg/L and (17.7±1.6) mg/L; all P ＜0.05].There were significant differences in the levels of NF-κB,P53 and mimecan in class Ⅰ,class Ⅱ,class Ⅲ and class Ⅳ in PAD group combined with type 2 diabetes group [NF-κB:(25.5±4.2) mg/L,(28.8±3.7) mg/L,(33.4±5.6) mg/L and (38.5±4.7) mg/L; P53:(2.5±1.1)mg/L,(2.9±1.0)mg/L,(3.7±1.2)mg/L and(4.6±1.3)mg/L; mimecan:(11.7±2.4)mg/L,(14.9± 1.8)mg/L,(17.4±2.5)mg/L and(20.7±2.8)mg/L; all P＜0.05].The levels of NF-κB,P53 and mimecan was increased with the aggravation of PAD (all P＜0.05).Conclusions The increased levels of NF-κB and P53 are correlated with the increase in mimecan level and Fontaine's classification.