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Objective To investigate the relationship of galectin-3 (Gal-3)and matrix metalloproteinase-9 (MMP-9)with in-stent restenosis (ISR).Methods We consecutively recruited 434 patients who had undergone successful drug eluting stent (DES)implantation.Then we divided them into ISR group (n=41)and NO-ISR group (n=393)according to the results of coronary angiography review.Independent risk factors for ISR were found out by multivariate analysis and the two groups were matched for these factors except for Gal-3 and MMP-9 .After elim-ination of the influence of confounders,serum Gal-3 and MMP-9 were compared between the groups and their rela-tions with the severity of ISR were analyzed.Patients were grouped based on Gal-3 and MMP-9 concentrations and major adverse cardiac events (MACEs)were compared between the two groups.Results After elimination of the influence of confounders,the results showed that serum levels of Gal-3 and MMP-9 were significantly higher in ISR group than in NO-ISR group (P＜0.001).Serum levels of Gal-3 and MMP-9 increased with the increased grade of classification.Serum levels of Gal-3 and MMP-9 were obviously higher in classes Ⅲ and Ⅳ ISR than in class Ⅰ (P＜0.05).Patients with higher levels of Gal-3 and MMP-9 had a higher incidence of MACEs (P＜0.01).ISR group had a higher incidence of MACEs than NO-ISR group (P＜0.05).Conclusion Serum levels of Gal-3 and MMP-9 are correlated with ISR and its severity,and they are independent risk factors for ISR.The rate of MACEs during follow-up period was increased with the increased levels of Gal-3 and MMP-9 .
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Objective To investigate the association of low level of free thyroxin (FT4)within normal range with the severity of coronary artery disease (CAD)and carotid atherosclerosis.Methods We enrolled 312 consecutive patients who underwent coronary angiography (CAG)and divided them into CAD group (196 cases)and non-CAD group (116 cases)according to CAG results.We calculated Gensini score and divided CAD group into≤10 Gensini score group (n=65),10-30 Gensini score group (n=67)and ＞30 Gensini score group (n=64).Thyroid hormone level,carotid intima-media thickness (CIMT)and other clinical data were measured and compared between the groups,and the correlation analysis was used to find the relationship of FT4 level with Gensini score.By taking CIMT reference value of 0.9 mm as the standard,we divided the patients into thickened IMT group (IMT≥0.9 mm)and normal IMT group (IMT＜0.9 mm).Results The level of FT4 was significantly lower in CAD group and subgroups than in non-CAD group (P＜0.05).The level of FT4 was negatively correlated with Gensini score (P＜0.05).The levels of FT4 and TT4 were significantly lower in thickened CIMT group than in normal CIMT group (P＜0.05).Conclusion Low level of FT4 within normal range is significantly related to the severity of CAD,and low level of FT4 can be used as an independent risk factor for the severity of CAD.Low levels of FT4 and TT4 are significantly related to carotid atherosclerosis.
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Objective To investigate the clinical therapeutic methods and their curative effects in recurrent ischemic angina for internal mammary artery resterosis after coronary artery bypass grafting (CABG).Methods We enrolled the patients who had recurrence of ischemic angina for restenosis of internal mammary artery graft after CABG as research subjects in the Affiliated Hospital of Yan'an University from January 2014 to January 2016.The 42 patients were divided into three groups according to the different treatment approaches for recurrence of ischemic angina:Group A (n=22)who received internal mammary artery interventional therapy;Group B (n=12)who received coronary artery bypass grafting treatment;and Group C (n=8)who received left subclavian artery proximal stent treatment.Then we compared the clinical therapeutic effects in the three groups.Results The success rate in Group C was 100%,which was the highest in the three groups,and the post-operative restenosis rate was 0.The hospitalization time was significantly shorter in Group A than in Group B (P＜0.05).However,the two groups did not significantly differ in mortality,success rate or restenosis rate (P＞0.05).Conclusion We should select the appropriate treatment according to the patient's specific situation for recurrent ischemic angina. Endovascular treatment has evident therapeutic effects,rapid postoperative recovery,and lower treatment risk, making it the preferred treatment when possible.
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Objective To investigate the predictive values of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR)before percutaneous coronary intervention (PCI)and a reexamination of coronary angiography (CAG)on the development of in-stent restenosis (ISR)in patients implanted with coronary drug eluting stent (DES).Methods For this study we enrolled 123 patients who had undergone successful drug eluting stent implantation (SI)and a further CAG reexamination.Another 45 patients with non-coronary heart disease (NC)served as controls.PLR and NLR were measured before DES implantation or CAG and compared between the groups.Patients in SI group were further divided into two subgroups based on the results of CAG reexamination:ISR group and no-ISR group.Hematologic data were reexamined before further CAG and compared between the subgroups.Receiver operator characteristic curve (ROC)was drawn to evaluate the predictive values of PLR and NLR for ISR.Results PLR and NLR before PCI or a further CAG were significantly higher in ISR group (34 patients)than in non-ISR group (89 patients,P＜0.05).Before PCI,the best cutoff value of PLR in screening restenosis was 107.20;the sensitivity and the specificity were 64.7% and 65.2%.The best cutoff value of NLR in screening restenosis was 2.72; the sensitivity and the specificity were 61.8% and 70.8%. Before CAG reexamination,the best cutoff value of PLR in screening restenosis was 160.08;the sensitivity and the specificity were 26.5% and 97.8%.The best cutoff value of NLR in screening restenosis was 2.08;the sensitivity and the specificity were 73.5% and 56.2%.Conclusion Both PLR and NLR before PCI or CAG reexamination can be predictors of ISR in patients implanted with DES.
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Objective To analyze the association of atherogenic index of plasma (AIP)and serum bilirubin with coronary in-stent restenosis after drug-eluting stent implantation.Methods For this research we recruited 268 patients who had undergone successful drug-eluting coronary stent implantation and then received coronary angiography.Both ends (from the edge of the supporting frame≤5 mm)or the vessel's diameter stenosis ≥50% were used as the definition of restenosis.According to the results of coronary angiography,the subjects were divided into restenosis group (42 cases)and non-restenosis group (226 cases).The total bilirubin,direct bilirubin,indirect bilirubin and AIP in the two groups were compared to explore the correlation of AIP and serum bilirubin with in-stent restenosis.Results AIP in restenosis group was significantly higher than that in non-restenosis group (P＜0.05).The level of total bilirubin was significantly lower in the former group than in the latter one (P＜0.05). Conclusion AIP is a risk factor for restenosis,and serum total bilirubin is a protective factor for coronary stent restenosis.
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Objective To investigate the relationship between ischemia-modified albumin (IMA) and coronary artery stenosis in patients without myocardial infarction.Methods For this study we consecutively enrolled 345 patients who received coronary angiography (CAG).According to the results,the subjects were divided into coronary stenosis group (232 cases)and control group (113 cases)to investigate the the relationship of IMA and IMA/albumin (IMAr)with coronary stenosis.Results ① The levels of IMA and IMAr in coronary stenosis group were higher than those in control group (P＜0.001).② The IMA and IMAr were higher in single-branch and multi-branch lesion groups than in control group (P＜0.05),whereas there was no significant difference between single-branch lesion group and multi-branch lesion group (P＞0.05).③ In receiver operating characteristics curve analysis,the sensitivity of IMA and IMAr was 64.4% and 78.0%,respectively (AUC:0.653,0.705,P＜0.001)in predicting coronary stenosis.④ Multivariate logistic regression analysis showed that IMAr was an independent risk factor for coronary stenosis in patients without myocardial infarction (OR=73.05,P＜0.001).Conclusion IMA and IMAr are closely correlated with coronary stenosis and have a value in predicting coronary artery stenosis in patients without myocardial infarction.
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Vascular endothelial injury is the initial manifestation of coronary atherosclerosis,and currently there are many researches on the mechanism of vascular endothelial injury.If the risk factors for coronary athero-sclerotic heart disease (CAD)are sustained and not reversed,endothelial dysfunction will occur,followed by coro-nary remodeling,and ultimately will lead to the occurrence of CAD.The study on the mechanism of vascular endo-thelial injury and vascular remodeling plays an important role in predicting the development of CAD and guiding the treatment of CAD.Percutaneous coronary intervention (PCI)is one of the main revascularizations for coronary heart disease.With the evolution of drug-eluting stents,the incidence of thrombosis and restenosis caused by vascu-lar endothelial injury after PCI is reduced.Biocompatibility of coronary stent technology is also improved based on the mechanism of vascular endothelial dysfunction and vascular remodeling.
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<p><b>OBJECTIVE</b>To explore the association of insulin resistance and β cell function with lipid metabolism in middle-aged and elderly Hui and Han populations.</p><p><b>METHODS</b>A total of 1000 subjects age over 40 years were recruited from five urban communities in Yinchuan and Wuzhong cities of Ningxia. The composition ratio between Hui and Han nationality was 1:2. A questionnaire-based survey was performed. Physical examinations were carried out to measure the height, body mass, waistline, and hipline. The levels of triglyceride (TG), total cholesterol (TC), blood uric acid (BUA), fasting blood glucose and insulin were measured. The boby mass index (BMI), waist-hip ratio (WHR), and secretion related index including insulin resistance index (IR), insulin sensitivity index (IAI), and beta cell function index (HBCI) were calculated.</p><p><b>RESULTS</b>The BMI, WHR, IAI, HBCI, and the prevalence rate of diabetes in Hui nationality were significantly higher than those in Han nationality (P<0.01). The levels of BUA, fasting blood glucose, TC, and IR in Han nationality were significantly lower than those in Hui nationality (P<0.01). In Hui populations, TG, BMI, WHR, and BUA were positively correlated with IR (r=0.234, r=0.193, r=0.143, and r=0.129, respectively; P<0.01) and were negatively correlated with IAI (r=-0.234, r=-0.193, r=-0.143, r=-0.129, respectively; P<0.01), whereas TC was negatively correlated with HBCI (r=-0.169, P<0.01). In Han populations, TC, TG, BMI, WHR, and BUA were positively correlated with IR (r=0.140, r=0.257, r=0.288, r=0.163, r=0.104, P<0.01) and negatively correlated with IAI (r=-0.140, r=-0.257, r=-0.288, r=-0.163, and r=-0.104, P<0.01), whereas BMI was negatively correlated with HBCI (r=-0.111, P<0.01). After the influential factors such as gender, nationality, and age were adjusted, the TC, TG, BMI, WHR, BUA levels were positively correlated with IR (r=0.109, r=0.256, r=0.253, r=0.139, and r=0.142, P<0.01) and negatively correlated with IAI (r=-0.109, r=-0.256, r=-0.253, r=-0.139, and r=-0.142, P<0.01). TC and BMI were negatively correlated with HBCI (r=-0.113, r=-0.086, P<0.01). TG and BMI were independently associated with IR and IAI (r=0.218, r=0.182, r=-0.218, r=-0.182), while TC and BMI were independently associated with HBCI (r=-0.113, r=-0.086).</p><p><b>CONCLUSIONS</b>The distributions of TC, TG, BMI, WHR, BUA, IR, IAI, and HBCI differ between Han and Hui populations. The development of insulin resistance is closely related with the increased levels of TC, TG, BMI, WHR, and BUA. However, the HBCI increases with the increased level of TC and BMI. TG and BMI may be related with insulin resistance. Also, TC and BMI may affect the secretion function of β cells.</p>