ABSTRACT
Objective Endothelial dysfunction is an important link in the development of coronary heart disease. The article aimed to evaluate reactive hyperemia index(RHI) level in patients with unstable angina pectoris(UAP) complicating diabetes mellitus(DM) and investigate its relationship with the degree of coronary artery stenosis. Methods TThe patients(n=300) diagnosed as UAP by coronary angiography (CAG) in our department were chosen and divided into DM group (UAP complicating DM, n=122) and NDM group(without DM, n=178). The severity of coronary artery stenosis was evaluated using the angiographic Gensini score. RHI levels were compared between two groups. Multiple linear regression analysis was used to analyze the correlations between RHI, angiographic Gensini score and risk factors. Results RHI level of DM group was found to be lower than that of NDM group(1.58±0.39 vs 1.70±0.24,P<0.05). Angiographic Gensini score was significantly elevated in DM group compared to NDM group[Gensini score:(61.76±64.79) vs (37.00±29.79),P<0.05]. The RHI levels of patients with Gensini scores of 31-59 points(1.64±0.28)and above 60 points (1.58±0.32) were significantly lower than those with scores less than 30 points (1.78±0.23) (P<0.05). The RHI level of patients with coronary heart disease(CHD) with three or more risk factors (1.49±0.43) was significantly lower than that of CHD patients with two or less risk factors (1.63±0.29) (P<0.05). Fasting blood glucose, glycosylated hemoglobin, coronary Gensini score, smoking and risk factors in the combined group were all negatively correlated with RHI(β=-0.010；-0.001；-0.177；-0.126；-0.001). Conclusion Gensini integrals are closely co-related to the degree of endothelial dysfunction, and severe endothelial dysfunction may be one cause of exacerbated coronary stenosis in the patients with UAP complicating DM.
ABSTRACT
Objective To explore the value of reactive hyperemia index (RHI) in predicting the postoperative angina pectoris (AP) in the patients with percutaneous coronary intervention (PCI).Methods Three hundreds and forty-seven patients with coronary heart disease treated by PCI therapy were continuously enrolled in our department from October 10 2015 to August 10 2016.RHI was detected in all cases during hospitalization period by using the noninvasive endothelial function test (Endo-PAT) technique.Then the cases were divided into the control group (RHI≥1.67) and observation group (RHI ＜1.67) according to RHI results.The incidence of AP after discharge from hospital,rehospitalization rate due to AP,frequency and duration of AP were observed in the two groups.Results The AP incidence rates in the control and observation group were 17.04％ and 31.13％ respectively,the difference was statistically significant(P=0.003);the re-hospitalization rate due to AP was 2.22％ and 7.55％ respectively,the difference was statistically significant(P =0.035);the incidence rates of AP attack≥5 times were 6.67 ％ and 16.51 ％ respectively(P=0.008);the duration of AP was (6.39±2.68) min and (8.67±2.58) min,respectively(P=0.001);the Logistic regression analysis showed that the Syntax scores≥23 points and RHI＜1.67 were the risk factors for AP recurrence after PCI(OR=2.265,95％CI:1.354-3.787,P=0.002;OR=2.110,95％CI:1.228-3.628,P=0.007).Conclusion Reduced RHI is closely related with recurrent AP after PCI,increases the incidence,rehospitalization rate due to AP,attack frequency and duration of AP.