ABSTRACT
Objective To analyze the influence of liraglutide intervention combined percutanous coronary intervention(PCI) therapy on acute myocardial infarction( AMI) with type 2 diabetes( T2DM) patients'myocardial injury, ventricular remodeling( VR), and cardiac function. Methods Eighty patients with AMI and T2DM were included in the study, and they were randomly divided into observation group and control group according to the random number table, each with 40 patients. The patients in the control group received metformin and conventional insulin combined PCI treatment, and the patients in the observation group received metformin and liraglutide combined PCI treatment. The changes in the values of ventricular remodeling indexes, cardiac function and serum related indexes were compared after 3 months treatment between the two groups. Results ( 1) The body weight and fasting blood glucose levels of the observation group were significantly lower than those of the control group( P＜0.05), and fasting insulin levels were significantly higher than those of the control group(P＜0.01). (2)The levels of N-terminal-pro-B- type natriuretic peptide ( NT-proBNP ), creatine kinase isoenzymes-MB ( CK-MB), and troponin I ( TnI) in the observation group 3 months after treatment were significantly lower than those in the control group(P＜0.05). (3)The levels of serum hypersensitive C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) in the observation group were significantly lower than those in the control group 3 months after treatment( P＜0. 05). ( 4) The values of left ventricular end systolic diameter ( LVESD ), left ventricular end diastolic diameter (LVEDD), interventricular septum thickness ( IVST), left ventricular posterior wall thickness ( LVPWT), left ventricular mass index ( LVMI), left ventricular end systolic volume ( LVESV), and left ventricular end diastolic volume(LVEDV) in the observation group were lower than those in the control group; the values of left ventricular fraction shortening(LVFS), left ventricular ejection fraction(LVEF), and mitral valve early diastolic blood flow rate (VE)/atrial systolic flow velocity ( VA), all were higher than those of the control group ( P＜0. 05). Conclusion Lraglutide intervention combined with PCI therapy on AMI with T2DM patients may reduce myocardial injury, induce ventricular remodeling, enhance cardiac function, and improve prognosis.
ABSTRACT
Objective To explore the correlation between the level of glucagon like peptide-1 (GLP-1) and the extent of coronary lesions in coronary heart disease (CHD).Methods One hundred and ninety-two CHD patients included in the study were divided into simple CHD group (n =60),CHD accompanied with impaired glucose tolerance(IGT) group (n =67),and CHD accompanied with type 2 diabetes mellitus (T2DM) group (n =65).48subjects were used as controls.The levels of GLP-1 in all the patients were analyzed by ELISA.Oral glucose tolerance test (OGTF) was performed.Blood glucose,insulin,and C-peptide levels were measured.The area under curves of insulin(AUCINS),C-peptide (AUCC-P),glucose (AUCGlu),and GLP-1 (AUCGLP-1) were calculated.All the patients underwent coronary angiography and the extent of coronary lesions was analyzed by total amount of coronary narrow degree integral.The association of GLP-1 level with coronary narrow degree was analyzed by correlation analysis and multivariate linear stepwise regression analysis.Results The levels of blood glucose and AUCGlu during OGTT in CHD accompanied with T2DM group were significantly higher than those in CHD with IGT group (P＜0.01),while the levels of insulin and C-peptide,AUCINS,and AUCC-P were decreased (P＜0.05).The levels of blood glucose,insulin,C-peptide,AUCGlu,AUCINs,and AUCC-P in CHD accompanied with IGT group were significantly higher than those in control group and simple CHD group (P＜0.01).Compared with simple CHD group and CHD accompanied with IGT group,GLP-1 level in CHD accompanied with T2DM group was markedly decreased(P＜0.01) while coronary artery narrow degree was raised(P＜ 0.05).Compared with simple CHD group,CHD accompanied with IGT group showed lower GLP-1 level and higher coronary artery narrow degree(P＜0.01).Correlation analysis revealed that GLP-1 level was negatively correlated with the coronary artery narrow degree in CHD patients (P ＜ 0.01).Multivariate linear regression analysis showed that systolic blood pressure,high density lipoprotein-cholesterol,fasting C-peptide and GLP-1 had a predictive effect on the coronary narrow degree integral in CHD patients.Conclusion The level of GLP-1 is closely correlated with the coronary artery narrow degree in CHD patients,especially in patients accompanied by hyperglycemia.