ABSTRACT
Objective To investigate the relationship between glycated albumin ( GA ) and extent of coronary lesions, GRACE score in patients with acute non?ST segmentelevation myocardial infarction ( NSTEMI) . Methods A total of 226 NSTEMI patients who successfully underwent coronary angiography ( CAG) were enrolled in the study. Groups:( 1) According to GA level,the patients were divided into 3 groups:GA17. 0% group. ( 2) According to the extent of coronary le?sions,the patients were divided into 2 groups:single or double branch lesion group,three and/or left main lesion group. ( 3) According to the GRACE score,the patients were divided into 3 groups:Low?risk GRACE score≤108 points group,Medium?risk 108 points140 points group. The extent of coronary lesions was evaluated by Gensini score. The clinical characteristics and Gensini score,GRACE score of each group were compared. Pearson/Spearman correlation analysis and logistic regression were used to analyze the association of GA with the severity of coronary artery disease and GRACE score. Results With glycated albumin increasing,the Gensini score(56. 51±38. 57,68. 30±35. 57,77. 38±36. 52),GRACE score(139. 43±29. 96,149. 77±38. 33,170. 75±27. 52) increased significantly,and significant differences were found between groups( F=5. 587,16. 006,P=0. 004,0. 000) . The ejection fraction( EF) of 3 groups were signif?icantly decrease((58. 30±13. 95)%,(56. 45±10. 79)%,(53. 06±12. 51)%;F=3. 126,P=0. 046). Proportion of severe coronary lesions of 3 groups were increase significantly( 59. 5%( 44/74) ,68. 2%( 60/88) ,87. 5%( 56/64),χ2=13. 528,P=0. 001). The level of GA in three and/or left main lesion group was higher than that in sin?gle or double branch lesion group((13. 92±3. 14)% vs. (16. 80±3. 58)%,t=-5. 693,P=0. 000). The level of GA in High?risk group was higher than that in Low?risk group ( ( 14. 70 ± 1. 54 )% vs. ( 16. 63 ± 4. 02 )%, t=6. 512,P=0. 002) . Correlation analysis showed that the level of GA had significant positive correlation with Gensini score and GRACE score(r=0. 309,0. 265;P=0. 000,0. 000),while had a negative correlation with LVEF(r=-0. 149,P=0. 034). Logistic regression analysis indicated that GA was independent risk factors for severity of coronary artery disease in patients with NSTEMI who successfully underwent CAG( OR=1. 441,95%CI:1. 160?1. 790,P=0. 001) . Conclusion GA level is increase in NSTEMI patients with severe coronary ar?tery disease and risk stratification high. GA is the independent risk factors for severity of coronary artery disease in patients with NSTEMI;GA has significant correlation with dangerous degree in patients with NSTEMI.
ABSTRACT
Objective To evaluate the diagnostic value of adenosine stress ~(99m)Tc-MIBI myocardial perfusion single photon emission computed tomography (ECT)in elderly patients with coronary artery disease (CAD). Methods Fifty-three patients aged ≥60 years without the history of myocardial infarction were included in the research. The average age of the patients was(65.5±6.5) years (60-78 years old). All patients underwent adenosine stress ~(99m)Tc- MIBI myocardial perfusion single photon ECT and coronary angiography (CAG) within 2 months, and the results were compared. Results Compared with CAG, the sensitivity, specificity, positive predictive value, negative predictive value and accurate index of ECT were 73.7%, 90.9%, 94.3%, 80.0% and 62.3%, respectively. The specificity for left anterior descending artery, left circumflex artery and right coronary artery of ECT were 90.9%, 85.7% and 100%, respectively, and the positive predictive values were 73.5%, 77.3% and 72.0%, respectively. Conclusions Adenosine is a strong vasodilator and it has multiple effects on cardiovascular system. Combination of angiocardiography and myocardial perfusion imaging can be used in diagnosis of coronary artery disease. ECT is a noninvasive, convenient and low cost method and plays an important role in diagnosing, directing treatment and judging prognosis of CAD in the elderly patients.
ABSTRACT
Objective To understand the correlation between insulin resistance(IR) and adrenal androgen excess in adolescents with polycystic ovary syndrome (PCOS). Methods According to BMI, 90 adolescents with PCOS were divided to groups of normal weight PCOS(NW-PCOS,33 cases,BMI<25.0 kg/m2) and obesity PCOS(OB-PCOS,57 cases, BMI≥ 25.0 kg/m2),and 15 normal weight healthy girls matched for age as controls.All patients had normal OGTT.Acute ACTH stimulating test was performed on patients, and cortisol (F), 17-hydroxyprogesterone(17-OHP), dehydroepiandrosterone(DHEA) during ACTH testing at 0 and 60 minute (steroid0 and steroid60) were determined. Results Compared with controls, NW-and OB-PCOS patients showed significantly greater levels of total testosterone (T), Luteotropic hormone(LH), FIns, 2 hIns, and HOMA-IR(P<0.01).The freqnencies of hirsuties and acne, and serum level of FIns, 2 hIns, and HOMA-IR were significantly higher and LH levels were much lower in the group of OB-PCOS than those in NW-PCOS(P<0.05 and P<0.01).ACTH stimulating test showed that PCOS patients had significantly higher levels of basal 17-OHP0, DHEA0, as well as 60-minute ACTH-stimulated levels (Steroid60) of 17-OHP60、DHEA60, and net increase of 17-OHP(Δ17-OHP)as compared with normal controls(P<0.05 and P<0.01).The 60-minute ACTH-stimulated levels of 17-OHP60, DHEA60,Δ17-OHP, and ΔDHEA were also higher in group of OB-PCOS than those in group of NW-PCOS(P<0.05 and P<0.01), and there were no obvious discrepancies in basal 17-OHP0, DHEA0 between OB-PCOS and NW-PCOS groups.Spearman correlation analysis showed that in group of OB-PCOS, HOMA-IR value was significantly associated with BMI, 17-OHP60, Δ17-OHP, DHEA60, ΔDHEA(P<0.05 and P<0.01); whereas in group of NW-PCOS, HOMA-IR was associated only with BMI(P<0.01). Conclusions The significantly higher basal and ACTH-stimulated levels of 17-OHP and DHEA indicates adrenal hyperresponsiveness in adolescents with PCOS.Adrenal androgen excess appears to be closely associated with insulin resistance in obese adolescents with PCOS
ABSTRACT
Objective To investigate the correlation between serum adiponectin level and severity of coronary artery disease.Methods We measured the serum concentrations of adiponectin in 135 patients whom had received CAG.The severity of coronary artery lesion was evaluated by Gensini score,the number of stenosis vessel and clinical manifestation.Results The serum concentrations of adiponectin in Gensini score 0 group(74.53?30.76 ng/mL)and score 40 group(28.96?11.87 ng/mL)(P40 group were lower than those in score 20-40 group(P
ABSTRACT
A cross sectional study of 769 patients was performed to evaluate the association of blood uric acid with coronary heart disease (CHD) in different metabolic disorders. It showed that uric acid was not independently associated with CHD. However, when the other abnormal metabolic factors were absent, uric acid might be related to CHD.
ABSTRACT
Objective To establish the rat model of acute stress during chronic heart failure and evaluate it.Methods Male Wistar rats were injected adrimycin(ADR)via abdominal cavity to induce heart failure.Cardiovascular dynamics and heart pathology were measured.Rats with heart failure received bacterial lipopolysaccharide(LPS)0.2 mg/kg by peritoneal injection to induce acute stress,and we measured blood pressure,heart rate and the expression of HO-1 after LPS injection.Results ADR peritoneal injection led to heart failure successfully.Compared with that in normal group,left ventricular function(?LVdp/dtmax)of rats in model group reduced significantly,and myocardial fibrosis and hypertrophy occurred,too.LPS peritoneal injection led to acute stress in rats with heart failure.Heart rate and blood pressure began to rise 0.5 h after LPS injection and reached at 1 h after LPS injection.The expression of myocardium HO-1 increased at 6 h and was significantly higher at 12 h after LPS injection.The expression of HO-1 was higher in model group than in normal group.Conclusion LPS peritoneal injection successfully leads to acute stress in rats with heart failure,providing a reliable model for study of decompensated heart failure.