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Objective: To explore the correlation among plasma fibrinogen (Fg), serum uric acid (SUA) level, severity of premature coronary heart disease (PCHD) and major adverse cardiovascular events (MACE).Methods:A total of 195 PCHD patients diagnosed by coronary angiography (CAG) were selected, including 72 cases with stable angina pectoris (SAP), 67 cases with unstable angina pectoris (UAP) and 56 cases with acute myocardial infarction (AMI).Another 75 healthy subjects were enrolled as normal control group.Plasma Fg and serum urea acid(SUA)levels were compared among four groups, and their relationship with coronary disease severity and incidence of MACE during six-month follow-up were analyzed.Then ROC curve was used to assess predictive value of plasma Fg and SUA levels for PCHD.Results: Compared with normal control group and SAP group, there were significant rise in levels of plasma Fg[(2.80±0.26) g/L, (2.85±0.32) g/L vs.(3.44±0.32) g/L, (4.25±0.35) g/L]and SUA[(306.56±15.55) μmol/L, (308.81±16.77) μmol/L vs.(349.48±15.59) μmol/L, (368.86±20.72) μmol/L]in UAP group and AMI group (P<0.05 or <0.01), and those of AMI group were significantly higher than those of UAP group (P<0.05 both);Spearman correlation analysis indicated that plasma Fg and SUA levels were significant positively correlated with Gensini score (r=0.750, 0.743, P<0.01 both);levels of plasma Fg and SUA in those suffering from MACE during follow-up were significantly higher than those of patients without MACE, P<0.05 or <0.01.Meanwhile, ROC curve suggested that plasma Fg and SUA possessed certain diagnostic value for PCHD[area under the curve (AUC) =0.867, 0.736].Conclusion: Plasma fibrinogen and serum uric acid detection can provide certain evidence for diagnosing PCHD and determining disease severity.
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Objective To investigate the variation and clinical significance of serum levels of inflammatory cyto-kines after percutaneous coronary intervention (PCI)treatment in acute myocardial infarction (AMI)patients. Methods 118 incipient AMI patients with successful underwent PCI (Defined as treatment group,blood samples were collected from pre-operation,12 h after operation,24 h after operation,48 h after operation and 90 d postop-erative follow-up period)and 52 AMI patients with diagnostic coronary angiography (CAG)(Defined as control group,blood samples were collected prior to CAG,12 h after CAG,24 h after CAG,48 h after CAG and 90 d fol-low-up period)were enrolled in this study.Serum levels of IL-6,IL-18,hs-CRP,TNF-αand MMP-9 were detec-ted in all the subjects by enzyme-linked immune sorbent assay(ELISA)and major adverse cardiac events(MACE) occurrence rate was analyzed in 90 days followed-up cases.Results No significant differences in baseline levels of IL-6,IL-18,hs-CRP,TNF-αand MMP-9 were found in the two study groups(P >0.05).No significant differences of levels of IL-6,IL-18,hs-CRP,TNF-αand MMP-9 were found after CAG in control group (P >0.05).The serum levels of IL-6,IL-18,hs-CRP and TNF-αafter PCI were significantly increased (P 0.05)in PCI group.There were significant differences of levels of IL-6,IL-18,hs-CRP and TNF-αbetween MACE group and without MACE group after PCI.The multivariable lo-gistic analysis showed that IL-6,IL-18,hs-CRP and TNF-αwere risk factors of MACE after 90 days follow-up. Conclusion The concentrations of serum IL-6,IL-18,hs-CRP and TNF-αare significantly increased in AMI pa-tients treated with PCI.PCI operation may induce inflammatory reaction.High serum levels of peripheral inflamma-tory cytokines IL-6,IL-18,hs-CRP and TNF-αhave an important role in major adverse cardiac events(MACE)and short-term prognosis in the first AMI patients treated with successful primary PCI.
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Objective To analyze the characteristic of some important clinical indicators, including carotid artery intima-middle thickness ( IMT) , peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 con-centrations of acute coronary syndrome ( ACS) patients. On the other hand, to investigate the correlation among those indicators and major adverse cardiac events ( MACE) , and further to evaluate the value of those indicators in early prediction and prognosis judgement of ACS patients with diabetes( DM) in clinic. Methods This study en-rolled 120 ACS patients who had received coronary arteriography( CAG) examination. Among them, 60 cases had DM. Meanwhile, 60 cases who had DM were selected as DM group,60 cases of healthy people who received physi-cal health examination were selected as the control group. Carotid artery IMT was determined by color doppler ultra-sonography. The levels of Fib in peripheral blood were detected by solidification method. Immune turbidimetric method and ELISA were used to measure the concentrations of serum IL-18 and MMP-9 respectively. The CAG re-sults, complications and in-hospital mortality of ACS patients were also collected and analyzed. Results Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS pa-tients were significantly increased compared with healthy control(P<0. 01). A comparison of those clinical indica-tors of ACS patients between with DM group and without 2 diabetes group showed a significant increase in ACS pa-tients with DM group. Carotid artery IMT, plasma Fib, serum IL-18, MMP-9 and Gensini score in ACS patients were positively correlated. The incidence of multi-vessel diseases of coronary artery was more frequent in ACS pa-tients with DM versus without DM ( 61. 7%) , while one or two vessel diseases of coronary artery was much more common in ACS patients without DM (61. 7%) . The Gensini score of ACS patients with DM group was much high-er than that of ACS patients without DM group ( P<0. 01 );severe and extremely severe lesions occurred more fre-quently in ACS patients with DM group (73. 3%) ,while mild-to-moderate lesions occurred more frequently in ACS patients without DM group (56. 7%) . Peripheral blood Fib levels, serum IL-18 and MMP-9 concentrations were significantly higher in ACS patients with MACEs compared to ACS patients without MACEs. Peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS diabetes mellitus extended the down-ward trend with the treatment time after standardized treatment show time-effect relationship. Conclusion Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentration and serum MMP-9 concentrations have great po-tential to become effective clinical indicators, which could be used to quantitatively predict coronary atherosclero-sis,and further to determine the risk degree and short-term prognosis of ACS patients with DM.
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Objective To evaluate the role of polymorphonuclear (PMN) in patients with acute myocardial infarction (AMI).The preventive effects of Vitamin C-a potent free radical scavenger,on parameters of PMN oxygen free radicals (OFR) production in patients with AMI were also studied.Methods 60 patients with AMI were randomized to receive either conventional treatment only (group Ⅰ,n=30) or conventional treatment supplemented with vitamin C infusion,3.0 g/d,for 7 days (group Ⅱ,n=30).Parameters of PMN OFR production were assayed by a method named as polymorphonuclear chemiluminescence (PMN-CL) on the 1st,3rd,7th and 10th day after been hospitalized.62 healthy controls of similar age,sex were also studied.Results Parameters of PMN-CL increased significantly in patients with AMI compared with that in the healthy controls.Parameters of PMN-CL decreased significantly in group Ⅱ on the 3rd,7th and 10th day compared with that in group Ⅰ(P<0.05,0.01,0.001,respectively).ST segment score was significantly higher in group Ⅱ than that in group Ⅰ on the 3rd,7th and 10th day.Conclusion These results indicate that the PMN act as a potential contributor to extension of tissue injury induced by OFR.Supplementation with vitamin C may suppress PMN OFR production and could be beneficial in preventing myocardial necrosis.