ABSTRACT
Objectives To investigate the relationship between atherosclerotic acute myocardial infarction (AMI),acute cerebral infarction (ACI)and homocysteine (Hcy). Methods Three hundred and twenty consecutive patients with primary acute myocardial infarction (AMI)(group A)were admitted to the Department of Cardiology,310 patients with primary large artery atherosclerotic cerebral infarction (group B)were admitted to the Department of Neurology,and 327 healthy individuals without cardiovascular and cerebrovascular diseases (group C)at the Department of Physical Examination,Xuanwu Hospital, Capital Medical University were enrolled retrospectively from March 2010 to October 2011. The age and sex were matched in the 3 groups. All the clinical data of subjects were colleted in detail and then were compared and analyzed. Results (1)The Hcy levels (μmol/L)of group A,B,and C were 15. 10 (12. 43, 19.47),15. 80 (13. 10,20. 83),and 13. 20 (11. 00,16. 50;median [interquartile range]),respectively. There were significant differences among the 3 groups (P<0. 05). The incidences of hyperhomocysteinemia (HHcy)were 92. 8%(n=297),97. 1%(n=301),and 84. 7%(n=277)(P<0. 05). (2)Multivariate Logistic regression analysis showed that the independent risk factors for ACI were HHcy (OR 8. 97,95% CI 3. 01-26. 71),hypertension,diabetes,hyperlipidemia and blood ureanitrogen;the independent risk factors for AMI were HHcy (OR 4. 36,95% CI 1. 70-11. 21),hypertension,diabetes,hyperlipidemia,and total blood cholesterol. Conclusion HHcy is an independent factor for ACI and AMI,which have closer relationship with ACI. ACI and AMI have some common risk factors,but their degrees of action are different.
ABSTRACT
Objective To analyze the incidence of stress hyperglycemia and its influential factors in patients with acute myocardial infarction and cerebral infarction. Methods The case data of 1630 consecutive patients with incipient myocardial infarction without cerebrovascular disease admitted in the department of cardiology and 1338 patients with atherosclerotic acute cerebral infarction without cardiovascular disease admitted in the department of neurology,Xuanwu Hospital,Capital Medical University from January 2009 to December 2012 were analyzed retrospectively. A total of 2048 patients without diabetes mellitus were selected from them,among them 1165 patients were in an acute myocardial infarction group and 883 were in a cerebral infarction group. The fasting blood glucose >7. 8 mmol/L in the next morning after admission was defined as hyperglycemia. Single factor and multifactor logistic regression analyses were used to compare the incidence of stress hyperglycemia and its influential factors of both groups. Results ( 1 ) Of the 1165 patients with myocardial infarction,the incidence of stress hyperglycemia was 17. 2% (n=201);of the 883 patients with cerebral infarction,the incidence of stress hyperglycemia was 5.4% (n=48). There was significant difference between the 2 group (χ2= 65.677;P < 0. 01). (2) Comparing the general information of the patients with stress hyperglycemia (n=249) and those without stress hyperglycemia ( n=1799) of the cardio-cerebrovascular diseases showed that there were significant differences in hyperlipidemia, drinking history, family history of cardio-cerebrovascular diseases, age, heart rate, total cholesterol, low density lipoprotein cholesterol,leukocyte count,blood urea nitrogen,and triacylglycerols between the 2 groups (P<0. 05). (3) Multivariate Logistic analysis showed that heart rate ( OR,1. 013,95%CI 1.002-1.024),leukocyte count (OR,1.109,95%CI 1.508-1.163),and triacylglycerols(OR,1.174, 95%CI 1. 042-1. 322) were the independent risk factors for stress hyperglycemia in myocardial infarction. (4) Systolic blood pressure (OR,1. 019,95% CI 1. 006-1.033) and leukocyte count (OR,1. 132,95%CI 1. 009-1. 268) were the independent risk factors for stress hyperg lycemia in cerebral infarction. Conclusion The incidence of stress hyperglycemia in patients with myocardial infarction is higher than that in patients with cerebral infarction,and the increased leukocyte count is a common independent risk factor for both.