Myocardial strain analysis by 4D-speckle tracking echocardiography for prediction of coronary artery disease severity in patients with stable angina pectoris

Objective: We sought to evaluate the myocardial strain by four-dimensional speckle-tracking echocardiography (4D-STE) in patients with stable angina pectoris (SAP) to determine the severity of coronary artery disease (CAD) based on the Gensini score. Methods: The present study comprised of 150 patients with SAP. Patients with history of SAP, normal left ventricular ejection fraction, and without regional wall motion abnormalities (RWMA) were scheduled for elective coronary angiography. Based on Gensini score, there were two groups: non-critical stenosis group [Gensini score (0e19), n ¼ 117] and critical stenosis group [Gensini score 20, n ¼ 33]. Correlation between Gensini score and 4D-STE strain parameters were investigated. Results: Out of 150 patients, critical stenosis group had significantly depressed values of all 4D-STE strain parameters than non-critical stenosis group (p < 0.001), except global radial strain (GRS) parameter. Significant positive correlation was found between Gensini score and 4D global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS) with Spearman's correlation coefficient (r) as 0.626, 0.548, and 0.631, respectively (p < 0.001), whereas significant negative correlation was found between Gensini score and GRS (r ¼ 0.433, p < 0.001). A 4D GLS value of 17 had 84.9% sensitivity and 97.4% specificity, GAS 31 (90.9% sensitivity, 78.6% specificity), GCS 17 (69.7% sensitivity, 92.3% specificity), and GRS <47 (sensitivity 72.7%, specificity 76.1%) to detect critical CAD described by Gensini score 20. Conclusion: The 4D-STE can aid in the assessment of severe CAD stenosis with good sensitivity and specificity in the patients with SAP without RWMA on traditional echocardiography.

Relationship between Duration of Diabetes Mellitus and Gensini Score in Patients Undergoing Diagnostic Coronary Angiography

Background: Gensini (G score) is one of the most widely used scoring systems in cardiology. It is an objective method to determine the coronary artery disease severity according to angiographic findings. The aim of this work was to assess the relation between G score and the chronicity of diabetes mellitus (DM) in cases undergoing coronary angiography. Methods: This prospective cohort research was carried out on 300 cases with diabetes mellitus (DM) on antidiabetic treatment who were referred to diagnostic coronary angiography for suspected coronary artery disease. G score was calculated for measurement of the coronary artery disease severity. During the period from October 2020 to Aril 2022 Results: Age, smoking, chronicity of DM, cholesterol, triglycerides test, and electrocardiogram were statistically prominent positively related with G score, while female gender was statistically significant negative relation with it. Also. Mean G score was statistically prominent higher in cases with ischemic changes than in cases without ischemic changes. Therefore, the chronicity of DM was statistically significant predictor of G score. Conclusions: significant positive relation between the G score and the chronicity of DM.

Correlation between monocytes and high-density lipoprotein cholesterol ratio and coronary artery stenosis in patients with unstable angina pectoris / 西安交通大学学报(医学版)

【Objective】 To investigate the correlation of monocytes and high-density lipoprotein cholesterol ratio(MHR) and albumin with the severity of coronary artery lesions in patients with unstable angina pectoris. 【Methods】 We enrolled 342 patients with unstable angina pectoris. According to the Gensini score of their coronary angiography results, they were divided into Gensini≤ 20 group, 20<Gensini ≤40 group, and Gensini >40 group. The differences in biochemical indicators between the groups were compared, and the correlation between the different indicators and the Gensini score was analyzed. According to the MHR quartile grouping, there were differences between the comparison groups. LDL-C was divided into subgroups and then subjected to multifactor Logistic regression analysis. 【Results】 MHR differed significantly among low, moderate and high grade lesions (P<0.05). Subgroup analysis showed that in low LDL-C group, Gensini score was positively correlated with MHR(P<0.05), while in high LDL-C group, Gensini score was negatively correlated with albumin(P<0.05). Multivariate Logistic regression analysis showed that the MHR level of patients with high Gensini score was 102.375 times higher than that of patients with low Gensini score(P<0.05). In the group with high LDL-C, the serum albumin level in the group with low Gensini score was 1.431 times that in the group with high Gensini score and 1.218 times that in the group with moderate Gensini score(all P<0.05). 【Conclusion】 In patients with unstable angina pectoris, especially when LDL-C levels are not high, both high MHR and low serum albumin are independent risk factors for the severity of coronary artery disease.

Serum Gamma Glutamyltransferase (GGT) in Coronary Artery Disease: Exploring the Asian Indian Connection

Background:There is a need to identify novel markers for CAD, independent of traditional CV risk factors. One of these is gamma?glutamyl transferase (GGT), a marker of increased oxidative stress. Given the high prevalence of CAD in Asian Indians, the link of GGT and CAD in them needs to be studied. Aim: To assess GGT in patients with angiographically documented CAD. Methods and Results: Two hundred patients aged 58.1 ± 9.95 years, 73% males, hypertension 56%, diabetes 40% were included. Mean GGT was 63.6 ± 44.33 (10–269 U/L). The levels of GGT progressively increased in those with single/double or triple?vessel CAD (36.5, 61.5, and 87 U/L, respectively, P < 0.001). Using objective criteria of CAD burden (SYNTAX and Gensini scores), we reaffirmed these findings. GGT in patients with SYNTAX tertiles 0–22, 23–32, and 33 was 33, 62, and 97 U/L, respectively and in Gensini tertiles 0–17.65, 17.66–56.65, ?56.66 was 32, 52, and 88 U/L, respectively, all P < 0.001. SYNTAX score 23 was present in only 23% patients in GGT tertile 1 (<41 U/L), whereas60% and 94% in GGT tertiles 2 and 3 had SYNTAX 23. Significant positive correlation was seen between GGT and SYNTAX (r = 0.634) and Gensini score (r = 0.772). Conclusions: In this study, GGT had an independent correlation with angiographic severity of CAD and SYNTAX and Gensini scores. Although the existing evidence seems biologically plausible, more studies are needed to explore the potential role of this inexpensive marker for predicting disease burden in patients with CAD.

Blood group B and decreased risk of coronary artery disease in hypertensive elderly / Grupo sanguíneo B y disminución del riesgo de enfermedad arterial coronaria en ancianos hipertensos

Abstract Although ABO blood groups have been associated with cardiovascular disease, little is known about whether ABO blood groups contribute to the risk of the presence and severity of coronary artery disease (CAD) in elderly individuals with hypertension. This study was aimed to explore this association. A total of 793 hypertensive patients aged ≥60 years out of 2095 patients who underwent primary coronary angiography were retrospectively included. They were divided into CAD and non-CAD groups. Demographic and clinical characteristics, ABO blood groups and other biochemical parameters were compared. Further evaluation was performed to determine the impact of ABO blood groups on CAD severity using the Gensini score and the number of significantly diseased vessels. A logistic regression model was constructed to identify the association of ABO blood groups with CAD. There was a substantial difference in the distribution of ABO blood groups in elderly and hypertensive adults with and without CAD (p=0.022). Hypertensive patients with CAD had a significantly lower proportion of the blood group B than those without CAD (p=0.008). Compared to those with non-Blood group B, hypertensive elderly with a blood group B tended to have significantly lower concentrations of TC, LDL -C and Apo B, and a lower number of significantly stenosed vessels. The blood group B was found to be an independent protective factor for CAD in elderly with hypertension. The blood group B is significantly associated with a decreased risk of CAD and is inversely correlated with the severity of coronary stenosis in the elderly with hypertension.

Resumen Aunque los tipos de sangre ABO están asociados con enfermedades cardiovasculares, se sabe poco sobre si los tipos de sangre ABO estás relacionados con la presencia y gravedad de la enfermedad arterial coronaria (CAD) en pacientes de edad avanzada con hipertensión. El objetivo de este estudio fue explorar esta relación. Se incluyeron retrospectivamente un total de 793 pacientes hipertensos de ≥60 años tomados de un grupo de 2095 pacientes sometidos a angiografía coronaria primaria. Se dividieron en el grupo de cardiopatía coronaria (CAD) y el grupo sin cardiopatía coronaria (no-CAD). Se compararon las características demográficas y clínicas, el grupo sanguíneo ABO y otros parámetros bioquímicos. El efecto del grupo sanguíneo ABO sobre la gravedad de la CAD se evaluó con la puntuación Gensini y el número de vasos sanguíneos patológicos significativos. Se construyó un modelo de regresión logística para determinar la relación entre el grupo sanguíneo ABO y la CAD. Hubo una diferencia significativa en la distribución de los grupos sanguíneos ABO entre los ancianos con y sin cardiopatía coronaria y los adultos con hipertensión (P=0,022). La proporción del grupo sanguíneo B en pacientes hipertensos con cardiopatía coronaria fue significativamente menor que en pacientes sin cardiopatía coronaria (P=0,008). En comparación con los grupos sanguíneos no B, las concentraciones de TC, LDL - C y Apolipoproteína B en los ancianos hipertensos del Grupo B fueron significativamente menores, y el número de estenosis vascular fue significativamente menor. El Grupo B es un factor protector independiente de la CAD en pacientes de edad avanzada con hipertensión. El Grupo B se correlacionó significativamente con la reducción del riesgo de cardiopatía coronaria y negativamente con la gravedad de la estenosis coronaria en pacientes de edad avanzada con hipertensión.

Níveis de Interleucina-35 em Pacientes com Doença Arterial Coronariana Estável / Interleukin-35 Levels in Patients with Stable Coronary Artery Disease

Resumo Fundamento Foi demonstrado que as subunidades de interleucina-35 (IL-35) estão fortemente expressas nas placas ateroscleróticas em humanos. Assim, considera-se que elas têm um papel na aterosclerose. Objetivos Neste estudo, os níveis de IL-35 foram comparados com o grupo controle em pacientes com doença arterial coronariana (DAC) estável, e a associação entre os níveis de IL-35 e o tipo, gravidade e extensão da lesão foram investigadas com o escore Gensini (GS) e o escore Syntax (SS) no grupo de pacientes Métodos Sessenta pacientes (18 mulheres e 42 homens) com DAC, diagnosticados por meio da angiografia coronária, que apresentaram dor no peito típica e teste de esforço não invasivo positivo, e 46 pacientes (18 mulheres e 28 homens) com luminograma normal, foram incluídos no estudo. Tanto o GS quanto o SS foram calculados para o grupo de pacientes, e esses valores foram comparados com os níveis de IL-35. Variáveis com distribuição não normal foram avaliadas com o teste U de Mann-Whitney, enquanto os parâmetros com distribuição normal foram analisados com o teste t de Student. A diferença entre as variáveis categóricas foi avaliada pelo teste de qui-quadrado ou de Fisher. Os valores de p<0,05 foram considerados como estatisticamente sinificativos. Resultados Não foram observadas diferenças significativas entre pacientes e o grupo controle em termos de características demográficas e achados laboratoriais. Em comparação ao grupo controle, os níveis de IL-35 no grupo com DAC foram consideravalmente menores (36,9±63,9 ng/ml vs. 33,2±13,2 ng/ml, p<0,008). Embora não tenha sido estatisticamente significativo, os níveis de IL-35 foram maiores em pacientes com SS mais baixo do que nos com SS mais alto (33,2±13,7 vs. 31,8±8,9, p=0,51). Os valores de IL-35 em pacientes com GS alto foram significativamente mais baixos do que em pacientes com GS baixo (35±17,4 vs. 30,7±8,6, p=0,043). Conclusão Demonstrou-se que os níveis de IL-35 podem ser um novo biomarcador para a DAC estável, e que a IL-35 está associada à extensão da DAC.

Abstract Background It has been shown that interleukin-35 (IL-35) subunits are strongly expressed in atherosclerotic plaques in humans. Therefore, it is considered to play a role in atherosclerosis. Objectives In this study, IL-35 levels were compared with the control group in patients with stable coronary artery disease (CAD), and the association between IL-35 levels and the lesion type, lesion severity and extension was investigated with the Gensini score (GS) and the Syntax score (SS) in the patient group. Methods Sixty patients (18 female and 42 male) with CAD diagnosed by coronary angiography, who presented with typical chest pain and positive noninvasive cardiac stress test, and 46 patients (18 female and 28 male) with normal coronary lumenogram, were included in this study. Gensini and Syntax scores were calculated in the patient group, and these values were compared with IL-35 levels. Non-normally distributed variables were analyzed by the Mann-Whitney U test, whereas normally distributed parameters were assessed by Student's t-test. The difference between categorical variables were evaluated by the Chi-square or Fisher test. P-values<0.05 were considered as statistically significant. Results No significant differences were observed between patients and the control group in terms of demographic characteristics and laboratory findings. Compared to the control group, IL-35 levels of the CAD group were considerably lower (36.9±63.9 ng/ml vs. 33.2±13.2 ng/ml, p<0.008). Although not statistically significant, IL-35 levels were higher in patients with low SS than among those with high SS (33.2±13.7 vs. 31.8±8.9, p=0.51). The IL-35 values of the patients with high GS were significantly lower than in patients with low GS (35±17.4 vs. 30.7±8.6, p=0.043). Conclusion It has been shown that IL-35 levels can be a new biomarker for stable CAD, and IL-35 is associated with the extension of CAD.

Correlation between serum osteopontin and osteopontin and type 2 diabetes mellitus with coronary heart disease / 中国综合临床

Objective:To study the relationship between serum osteopontin and osteopontin and type 2 diabetes mellitus (T2DM) complicated with coronary heart disease, and to evaluate the correlation between the levels of serum osteopontin and osteopontin with the severity of coronary artery lesions in T2DM patients.Methods:A total of 100 T2DM patients who were suspected to have stable coronary heart disease and underwent coronary angiography from November 2019 to December 2020 were selected from the Affiliated Hospital of Chengde Medical College, according to coronary angiography results, 60 patients with confirmed coronary heart disease were classified as the case group and 40 patients with non-coronary heart disease were classified as the control group for retrospective analysis. The clinical data and biochemical indicators of all patients were recorded, and Gensini score was calculated. The concentration of osteopontin and osteopontin in serum was quantitatively determined by double-antibody enzyme linked immunosorbent assay method. Independent sample t-test was used to compare the mean of normal distribution measurement data between the two groups. The non normal distribution data are represented by M ( Q1, Q3), and Mann Whitney U test is used for comparison between groups. Composition comparison between count data groups χ 2 inspection. Spearman correlation analysis was used to analyze the correlation between serum osteopontin and osteopontin and Gensini score in patients with T2DM. Results:Univariate analysis showed that serum osteopontin and osteopontin were (13.076(8.433, 23.552) μg/L) and (0.437(0.300, 0.630) μg/L) significantly higher in the case group than in the control group (6.367(4.605, 9.048) μg/L) and (0.299(0.196, 0.399) μg/L) respectively, with statistically significant differences ( Z=5.12, 3.28, all P<0.001). Multi-factor logistic regression analysis showed that osteoprotegerin ( OR=2.887, 95% CI:1.850-8.515, P=0.024) and osteopontin ( OR=13.109, 95%CI: 2.557-67.204, P=0.002) were associated with T2DM combined with coronary heart disease, and the risk of T2DM combined with coronary heart disease increased with higher levels of osteoprotegerin and osteopontin. Spearman correlation analysis showed that serum osteopontin and osteoprotegerin were positively correlated with Gensini score in T2DM patients ( r=0.591, 0.467; all P<0.05). Conclusion:Serum osteopontin and osteoprotegerin are associated with T2DM combined with coronary heart disease, and high serum osteopontin and osteoprotegerin are risk factors for T2DM combined with coronary heart disease; serum osteopontin and osteoprotegerin are positively correlated with the degree of coronary artery disease in T2DM patients.

Correlation between neutrophil/lymphocyte ratio combined with low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and severity of coronary artery disease in patients with acute coronary syndrome / 中华危重病急救医学

Objective:To investigate the correlation between neutrophil/lymphocyte ratio (NLR) combined with low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (LDL-C/HDL-C) and severity of coronary lesions in patients with acute coronary syndrome (ACS).Methods:Patients who were diagnosed with ACS due to chest pain and received emergency coronary angiography in the First Affiliated Hospital of University of Science and Technology of China and the Affiliated Hospital of Anhui Medical University from January 2017 to June 2020 were enrolled in the final analysis. The data of gender, age, body mass index (BMI), past history, emergency blood routine indicators [neutrophil (NEU), lymphocyte (LYM), monocyte (MON), eosinophil (EOS), basophil (BAS), red blood cell (RBC), mean corpuscular volume (MCV), blood red cell distribution width (RDW), mean platelet volume (MPV), platelet volume distribution width (PDW)], blood lipid index [triglyceride (TG), total cholesterol (TC), HDL-C, LDL-C, very low-density lipoprotein cholesterol (VLDL-C)], and coronary angiography were collected. The results of coronary angiography were evaluated by the Gensini score. According to the Gensini score, the patients were divided into the control group (Gensini score = 0, 55 cases) and the study group (Gensini score > 0, 889 cases), and then the patients in the study group were divided into the low-Gensini-score group (Gensini score < 66, 419 cases) and the high-Gensini-score group (Gensini score ≥ 66, 470 cases). The differences in the general baseline data of the four groups were compared, and the correlation between the statistically significant data and the Gensini score was linearly analyzed, and then the combined diagnostic factors (NLR combined with LDL-C/HDL-C ratio) were obtained by Logistic regression analysis. The receiver operator characteristic curve (ROC curve) was used to evaluate the predictive value of NLR combined with LDL-C/HDL-C ratio in predicting the severity of coronary artery lesions in patients with ACS. Finally, multivariate linear regression analysis was used to establish the predictive model between NLR combined with LDL-C/HDL-C ratio and Gensini score.Results:A total of 944 patients were finally included. The differences in gender, age, BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, EOS, RDW, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C ratio between the control group and the study group were statistically significant. The differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, EOS, TG, TC, HDL-C, LDL-C, NLR and LDL-C/HDL-C ratio between the low-Gensini-score group and the high-Gensini-score group were statistically significant. Linear regression analysis showed that compared with other indicators, the correlation between NLR, LDL-C/HDL-C ratio and Gensini score was stronger in the study group ( r values were 0.634 and 0.663, respectively, both P < 0.05). Binary Logistic regression analysis of the indicators related to Gensini score showed that NEU, LYM, HDL-C and LDL-C were independent risk factors for coronary stenosis in patients with ACS [odds ratio ( OR) were 0.189, 10.309, 13.993, 0.251, 95% confidence intervals (95% CI) were 0.114-0.313, 4.679-22.714, 3.402-57.559, 0.121-0.519, respectively, all P < 0.05]. ROC curve analysis showed that NLR combined with LDL-C/HDL-C ratio had higher predictive value in predicting the severity of coronary lesions in ACS patients [area under the ROC curve (AUC) was 0.952, 95% CI was 0.93-0.969], when the cutoff value was -3.152, the sensitivity was 98.20%, and the specificity was 81.60%. According to the results of multivariate linear regression analysis, the prediction model between NLR, LDL-C/HDL-C ratio and Gensini score was established, and the formula was Gensini score = -7.772+15.675×LDL-C/HDL-C ratio+8.288×NLR ( R2 = 0.862). Conclusion:There is a significant correlation between emergency NLR combined with LDL-C/HDL-C ratio and Gensini score in patients with ACS at admission, which has a certain predictive value for the severity of coronary artery stenosis in patients with ACS, and can be used as a predictor for evaluating the severity of coronary artery disease.

Changes of serum NT-pro BNP and Lp (a) levels in patients with acute mocardial infarction after emergency PCI and their clincal significances / 吉林大学学报(医学版)

Objective: To investigate the changes of the levels of amino-terminal pro-brain natriuretic peptide (NT-pro BNP) and lipoprotein a [Lp (a)], and to clarify the relationships between the severity of coronary artery lesions and the prognosis in the patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCD. Methods: A total of 316 AMI patients underwent emergency PCI were selected. According to the number of stenosed coronary vessels, the patients were divided into single-vessel disease group (n=135), double-vessel disease group (n= 99) and three-vessel disease group (n=82). According to the Gensini score, there were 79 cases in 83. 00 group. The patients' general data, biochemical parameters, echocardiography results, and coronary angiography findings were recorded, and the major adverse cardiovascular events (MACE) were also recorded during a 12-month folow-up. The relationships between the serum NT-pro BNP and Lp (a) levels of the AMI patients in different lesion counts and Gensini scores, and the recent Accurrence of MACE were analyzed. The receiver operating characteristic (ROC) curve was drawn to investigate the values of NT-pro BNP and Lp (a) levels on predicting the recent MACE in the patients with AMI. Results: The serum NT-pro BNP levels of the patients in three-vessel disease group and double-vessel disease group were higher than that in single-vessel disease group (P< 0.01); the serum Lp (a) level of the patients in three-vessel disease group was higher than that in single-vessel disease group (P<0.05). According to Spearman correlation analysis, there were positive correlations between the serum NT-pro BNP level, Lp (a) level of the AMI patients and the number of coronary vessels (r=0.285, P< 0.01; r=0.144, P=0.010); there were positive correlation between the serum NT-pro BNP level, Lp (a) level and Gensini score of coronary lesions (r=0.156, P=0.006; r=0.164, P=0.003). The serum NT-pro BNP and Lp (a) levels of the patients with MACE during follow-up were higher than those in the patients without MACE. The ROC curve showed that the area under the curve (AUC) of the levels of serum NT-pro BNP and Lp (a) was 0.747 (95%CI: 0.679-0.814). Conclusion: The serum NT-pro BNP and Lp (a) levels have the certain relationships with the severity of coronary artery lesions in the AMI patients after PCI. The simultaneous detection A serum NT-pro BNP and Lp (a) levels has certain predictive value for the recent Accurrence of MACE in the AMI patients underwent emergency PCI.

Correlation between serum vitamin D and coronary artery lesion severity and short-term prognosis in patients with coronary artery disease / 上海交通大学学报（医学版）

Objective: To explore the relationship between serum vitamin D level and coronary artery lesion severity and short-term prognosis in coronary artery disease (CAD) patients. Methods: A total of 323 CAD patients diagnosed according to coronary angiogram were selected and the coronary artery lesion severity was evaluated by using Gensini score. Clinical data was collected and serum level of vitamin D and other indicators were determined for statistical analysis. Results: All patients were divided into tertile according to Gensini score. The level of serum vitamin D concentration was significantly different from the lowest tertile to the highest tertile (P=0.000). Serum vitamin D level was negatively correlated with Gensini score in CAD patients (r=-0.182, P=0.001). Multivariate linear analysis showed that vitamin D level was an independent predictor of Gensini score (β=-0.795, P=0.000). There was no difference in the incidence of major advanced cardiovascular events between vitamin D deficiency patients and normal vitamin D level patients (2.05% vs 3.17%, P=0.202) after (18.14±3.04) months' follow-up. Conclusion: There is an independently negative correlation between serum vitamin D and coronary artery lesion severity in CAD patients.

Mean platelet volume combined with Gensini score in prediction of short-term prognosis in patients with acute ST segment elevation myocardial infarction after emergency percutaneous coronary intervention / 中国介入影像与治疗学

Objective To investigate the value of mean platelet volume (MPV) combined with Gensini score in predicting short-term prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI). Methods A total of 186 patients with STEMI who underwent emergency PCI were enrolled. The relevant laboratory tests were completed before PCI, and MPV was detected. Gensini score was obtained according to the results of coronary angiography. The occurrence of major adverse cardiovascular events (MACE) after PCI was recorded. Then statistical analysis was performed. Results There were 36 patients with MACE after PCI (MACE group) and 150 patients without MACE (non-MACE group). The total cholesterol (TC), platelet count (Plt), D-dimer, N-terminal pro-brain natriuretic peptide (NT-proBNP), MPV, Gensini score and the proportion of lesions involving three vessels of coronary arteries were statistically different between the two groups (all P<0.05). MPV, Gensini score, Plt, NT-proBNP and lesions involving three vessels of coronary arteries were independent risk factors for MACE after PCI in patients with STEMI (all P<0.05). ROC analysis showed that the AUC for MPV (threshold as 0.86 fl) combined with Gensini score (threshold as 82.17) in predicting MACE in patients with STEMI after PCI was 0.92(95%CI [0.87, 0.98]), the sensitivity and specificity was 92.70% and 83.33%, respectively. Conclusion The occurrence of MACE in patients with STEMI after emergency PCI is related to MPV and Gensini score before intervention. MPV combined with Gensini score can be used to screen out high-risk patients.

Correlation of Apo-A and Apo-B/Apo-A ratio with the degree of coronary artery stenosis in patients with coronary heart disease / 西安交通大学学报(医学版)

Objective: To investigate the correlation of Apo-A and Apo-B/Apo-A ratio with the degree of coronary artery stenosis (CHD) in patients with coronary heart disease. Methods: Totally 234 patients with coronary heart disease examined with coronary angiography were collected. We collected blood lipid and calculated blood lipid ratio, such as non-HDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C, and Apo-B/Apo-A. Gensini score was calculated according to the result of CAG. We analyzed the correlation between the blood lipid indicators and the Gensini score with the Spearman correlation analysis. Linear regression analysis was made of the correlation between those meaningful indicators and the Gensini score. Results: There were no significant differences in age, hypertension, diabetes or smoking index between all Gensini score groups. The illness course in middle-score group was longer than that in low-score group and high-score group (P=0.023, P=0.002). There was a significant difference in Apo-A between the groups (P=0.009, P<0.001, P=0.013). The levels of TC, Apo-B and LPα in high-score group were lower than those in low-score group (P=0.008, P=0.001, P=0.002). The levels of HDL-C and Apo-B/Apo-A ratio in both middle-score and high-score group were lower than those in low-score group (P=0.008, P=0.001). The Spearman correlation analysis between various risk factors and Gensini score found that HDL-C and Apo-A had negative correlation with Gensini score (r=-0.166, r=-0.294), the ratios of LDL-C/HDL-C and Apo-B/Apo-A were positively correlated with Gensini score (r=0.159, r=0.170). By multi-factor linear regression, Apo-A was negatively related with Gensini score (β=-62.249), and Apo-B/Apo-A ratio was positively associated with Gensini score (β =31.311). Conclusion: Apo-A and Apo-B/Apo-A ratios are the independent risk factors for the stenosis degree of coronary artery in patients with CHD. They are reliable predictors for the risk of CHD.

Clinical Efficiency of Modified Yuyetang to Type 2 Diabetes Mellitus Combined with Coronary Heart Disease / 中国实验方剂学杂志

Objective: To discuss the clinical effect of modified Yuyetang to type 2 diabetes mellitus (T2DM) combined with coronary heart disease (deficiency of Qi and Yin or phlegm syndrome and stasis syndrome) and the mechanisms of anti-inflammation and anti-oxidation. Method: One hundred and eighteen patients were randomly divided into control group (58 cases) and observation group (60 cases) by random number table. Patients in control group was orally given insulin or special blood glucose for hypoglycemic agents, aspirin enteric-coated tablets, 100 mg/time, 1 time/day. Patients with dyslipidemia got atorvastatin, 10 mg/time, 1 time/day. And patients with hypertension got captopril tablets, 12.5-25.0 mg/time, 1 time/day. In addition to the therapy of control group, patients in observation group were also given modified Yuyetang, 1 dose/day. A course of treatment was 3 months. Before and after treatment, levels of glycated hemoglobin (HbA1c), fasting blood glucose (FPG), 2-hours postprandial glucose (2 hPG), blood lipids triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HLD-C), low-density lipoprotein (LDL-C), apolipoprotein A (ApoA), apolipoprotein B (ApoB), procalcitonin (PCT), homocysteine (Hcy), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and hypersensitive C-reactive protein (hs-CRP), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and 8-Isoprostaglandin F2a (8-ios-PGF2a) were detected, Gensini and traditional Chinese medicine (TCM) syndrome were scored, and electrocardiogram was detected. Result: After treatment, levels of FPG, HbA1c, LDL-C, ApoB, scores of Gensini and TCM syndrome, PCT, Hcy, IL-6, TNF-α and hs-CRP in observation group were all lower than those in control group (PPPPPPConclusion: In addition to hypoglycemic, lipid-lowering and antiplatelet therapies, Modified Yuye decoction can regulate glucose and lipid metabolism of patients with T2DM and coronary heart disease, relieve degree of coronary artery stenosis, with anti-inflammatory and anti-oxidative stress effect.

Correlation of lipoprotein(a) with clinical stability and severity of coronary artery lesions in patients with coronary artery disease / 南方医科大学学报

OBJECTIVE@#To analyze the correlation of lipoprotein(a) [Lp(a)] with the clinical stability and severity of coronary artery stenosis in patients with coronary artery disease (CAD).@*METHODS@#A total of 531 patients undergoing coronary angiography in Nanfang Hospital between January, 2013 and December, 2016 were enrolled in this study. At the cutoff Lp(a) concentration of 300 mg/L, the patients were divided into high Lp(a) group (=191) and low Lp(a) group (=340). In each group, the patients with an established diagnosis of CAD based on coronary angiography findings were further divided into stable angina pectoris (SAP) group and acute coronary syndrome (ACS) group. The correlation between the severity of coronary artery stenosis and Lp(a) was evaluated.@*RESULTS@#The patients in high and low Lp(a) groups showed no significant differences in age, gender, body mass index, smoking status, hypertension, or diabetes (>0.05). Multivariate logistic regression analysis revealed that age, gender, and serum levels of low-density lipoprotein cholesterol (LDL-C) and Lp(a) were independent risk factors for CAD in these patients. A high Lp(a) level was associated with an increased risk of CAD (OR=2.443, 95%CI: 1.205-4.951, =0.013). The patients with a high Lp(a) level were at a significantly higher risk of CAD than those with a low Lp(a) level irrespective of a low or high level of LDL-C (=0.006 and 0.020). In the patients with CAD, the ACS group had a significantly higher Lp(a) level than the SAP group ( < 0.001); the proportion of the patients with high Gensini scores was significantly greater in high Lp(a) group than in low Lp(a) group (17.3% vs 5.6%, =0.026), and a linear relationship was found between Lp(a) level and Gensini score (R=0.130, =0.006).@*CONCLUSIONS@#Serum level of Lp(a) is an independent risk factor for CAD, and an increased Lp(a) is the residual risk for CAD. In patients with CAD, a high Lp(a) level is associated with the clinical instability and severity of coronary artery stenosis.

Association between neutrophil to lymphocyte ratio and severity of coronary artery disease

Background: Atherosclerosis is a chronic systemic inflammatory disease. Neutrophil-to-lymphocyte ratio (NLR) is systemic inflammatory marker that is correlated with poor cardiovascular outcome. The aim of this study was to investigate the association between neutrophil to lymphocyte ratio (NLR) and severity of coronary atherosclerosis.Methods: A total of 324 patients undergoing coronary angiography were included in the study. All the patients were included in study were divided into two groups based on the result of coronary angiography report. While 226 patients had abnormal coronary angiography (case) (78 female, mean age: 60.6�.6 years), 98 patients had normal coronary angiography (control) (60 female, mean age: 57.2�.9 years). NLR was calculated as the ratio of neutrophil count to lymphocyte count.Results: Although age distribution was similar between the two groups(p = 0.073), female gender was significantly higher in the normal coronary angiography group (p < 0.001). Smoking history has shown a significant higher in cases compared to the normal coronary angiography (p=0.001). Patients with abnormal coronary angiography had significantly higher NLR when compared to patients with normal coronary angiography (p<0.001). NLR was significantly correlated with Gensini score. In logistic regression analyses, NLR was an independent predictor of CAD. An NLR of 2.34 or higher predicted the CAD with a sensitivity of 66% and specificity of 70%.Conclusions: There is significant association between severity of coronary artery disease and neutrophils to lymphocyte ratio. This study suggests that the NLR is an independent predictor of coronary heart disease that may be useful for cardiac risk stratification in patients with coronary artery disease.

Correlation between LDL-C/HDL-C Ratio and the Severity of Coronary Artery Lesion in Patients with Coronary Heart Disease / 中山大学学报(医学科学版)

[Objective]To explore the correlations between different indices of lipoprotein cholesterol and apolipopro-tein of coronary heart disease(CHD)patients,especially that between low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)and that between apolipoprotein A1(apoA1)and apolipoprotein B100 (apoB100),as well as the correlations between these indices,indices ratios and the severity of coronary artery lesion.[Methods]301 coronary heart disease patients hospitalized to accept percutaneous coronary intervention(PCI)in the Third Affiliated Hospital of Sun Yat-sen University during 2013-2014 were recruited in the study. Fasting serum lipid indices including triglycerides(TG),total cholesterol(TC),LDL-C,HDL-C,apoA1 and apoB100 were examined before surgery.Gensini score was calculated to evaluate the severity of coronary artery lesion. 153 patients whose Gensini score was less than 50 were assigned to Group A,while 148 patients with Gensini score greater than or equal 50 were distributed to Group B.[Results]Positive correlations were found between LDL-C and HDL-C(r=0.161,P=0.005), apoA1 and apoB100(r=0.358,P<0.001),apoB100 and LDL-C(r=0.487,P<0.001),apoA1 and LDL-C(r=0.178, P=0.002)by linear correlation analysis. No significant correlation was found between apoB100 and HDL-C. None of LDL-C,HDL-C,TC was correlated with Gensini score. However,LDL-C/HDL-C ratio was positively correlated with Gensini score(r=0.148,P=0.01). The results showed no significant correlations between apoB100,apoB100/apo A1 ratio and Gensini score but negative correlation between apoA1 and Gensini score(r=-0.129,P=0.025). The positive correlation between HDL-C/LDL-C ratio and Gensini score was still valid after multi-factors adjustment (β=5.071,P=0.018).[Conclusion]Of patients with coronary heart disease,there exist some correlations between LDL-C and HDL-C,apoA1 and apoB100,while the correlation between LDL-C and HDL-C is relatively weak.The LDL-C/HDL-C ratio,weakly positively correlated with the severity of coronary artery lesion,is a risk factor of coronary artery lesion,while the level of apoA1,negatively correlated with the severity of coronary artery lesion,could play a protective role.

Relationship Between Serum Bilirubin Level and the Severity of Coronary Artery Disease / 中国循环杂志

Objective: To explore the relationship between serum bilirubin level and the severity of coronary artery disease (CAD). Methods: A total of 568 patients treated in our hospital from 2014-07 to 2016-03 were studied. Based on coronary angiography (CAG), the patients were divided into 2 groups: CAD group, n=438 and Non-CAD group, n=130. CAD group had 166 patients with single vessel disease, 150 with double vessel disease and 122 with triple vessel disease; taking Gensini score 34 as the border, there were 219 patients with low Gensini score and 219 with high Gensini score. Taking total bilirubin (TBIL) level>17.1 μmol/L as the border, the patients were divided into another set of 2 groups: Normal TBIL group, n=426 and High TBIL group, n=142. Clinical data, biochemical parameters, blood routine examination, color doppler ultrasound and CAG results were recorded. Blood levels of TBIL, direct bilirubin (DBIL) and indirect bilirubin (IBIL) were compared among different groups. Results: ①Compared with Non-CAD group, CAD group had decreased serum levels of TBIL, DBIL and IBIL, P<0.05, the detective rate of hyperbilirubinemia had decreasing trend; while detective rate of CAD was similar between Normal TBIL group and High TBIL group, P>0.05. ②In CAD group, the patients with more coronary branch lesions and the higher Gensini scores had the lower serum levels of TBIL, DBIL and IBIL, P<0.05. Pearson correlation analysis showed that TBIL, DBIL and IBIL were positively related to LVEF (r=0.390, r=0.283 and r=0.426), all P<0.05. ③Multi-linear regression analysis indicated that DBIL, IBIL level was the independent risk factor for CAD occurrence and having negative correlation to CAD (B=-3.766, B=-2.705), both P<0.05. ④TBIL, DBIL and IBIL levels were negatively related to hs-CRP in CAD patients (r=-0.617, r=-0.473 and r=-0.580),allP<0.05. Conclusion: Serum bilirubin level was negatively correlated to the degree of the cornary stenosis, which is independent of its forms, low bilirubin might be an independent risk factor of CAD occurrence.

Association of low levels of free thyroxin within normal range with the severity of coronary artery disease and carotid atherosclerosis / 西安交通大学学报(医学版)

Objective To investigate the association of low level of free thyroxin (FT4)within normal range with the severity of coronary artery disease (CAD)and carotid atherosclerosis.Methods We enrolled 312 consecutive patients who underwent coronary angiography (CAG)and divided them into CAD group (196 cases)and non-CAD group (116 cases)according to CAG results.We calculated Gensini score and divided CAD group into≤10 Gensini score group (n=65),10-30 Gensini score group (n=67)and ＞30 Gensini score group (n=64).Thyroid hormone level,carotid intima-media thickness (CIMT)and other clinical data were measured and compared between the groups,and the correlation analysis was used to find the relationship of FT4 level with Gensini score.By taking CIMT reference value of 0.9 mm as the standard,we divided the patients into thickened IMT group (IMT≥0.9 mm)and normal IMT group (IMT＜0.9 mm).Results The level of FT4 was significantly lower in CAD group and subgroups than in non-CAD group (P＜0.05).The level of FT4 was negatively correlated with Gensini score (P＜0.05).The levels of FT4 and TT4 were significantly lower in thickened CIMT group than in normal CIMT group (P＜0.05).Conclusion Low level of FT4 within normal range is significantly related to the severity of CAD,and low level of FT4 can be used as an independent risk factor for the severity of CAD.Low levels of FT4 and TT4 are significantly related to carotid atherosclerosis.

The relationship between body mass index and coronary artery lesion of the clinical experience in nursing / 中国实用护理杂志

Objective To investigate the relationship between body mass index (BMI) and Gensini score,to assess the predictive value of myocardial infarction. Methods Totally 348 patients with myocardial infarction and 1054 patients with non- myocardial infarction from January 2014 to August 2015.To analyze the difference of BMI and Gensini scores between the two groups. To analyze the relationship between BMI and Gensini scores in each group, and the value of BMI used to predict the risk of myocardial infarction. Results The BMI and Gensini scores of the myocardial infarction group were significantly higher than those of the non- myocardial infarction group. There was a positive correlation between BMI and Gensini score in the MI group (r=0.304, P=0.000). The BMI of the non-myocardial infarction group was positively correlated with Gensini's score (r=0.253, P=0.000). AUC was 0.647, P=0.000, 95％ CI (0.617, 0.678), the risk of myocardial infarction was measured by ROC analysis. Conclusions The level of BMI in patients with coronary heart disease is associated with Gensini scores. BMI can be used as an effective indicator of myocardial infarction in the patients of coronary heart disease

Clinical study on the relationship between coronary artery lesion and cardiac function in patients with coronary heart disease / 重庆医学

Objective To investigate the relationship between coronary artery lesion and cardiac function in coronary atherosclerotic heart disease (CHD) patients.Methods Ninty cases of patients with CHD who were hospitalized for chest pain in Air Force PLA General Hospital and scheduled for coronary angiography were selected.Noninvasive hemodynamie testing was performed before coronary angiography.According to the results of coronary angiography,74 patients with coronary artery stenosis were selected as disease group,persons with an additional angiography showed no coronary artery stenosis and excluded from other systemic diseases in physical examination center(30 cases) were chosed as control group.According to the results of coronary angiography,the Gensini score system was used to quantify the degree of coronary artery disease,the patients were divided into two groups according to the score.:high score group (Gensini score＞ 20 points,40 cases) and low score group (Gensini score≤20).And the relationship between coronary artery stenosis and cardiac function was analyzed by comparing the two groups of noninvasive hemodynamics cardiac function indexes,BNP and LVEF values.Results The levels of C,SV,CO,CI,HI and LVEF in the disease group were significantly lower than those in the control group (P＜0.05),Q-B/B-X was significantly higher than that in the control group (P＜0.05);There were statistically significant of BNP and LVEF between Gensini high score and low score group (P＜0.05).The Pearson correlation analysis showed there was significantly negatively correlated between Gensini score and C,SV,CO,CI,HI,LVEF,and significantly positively correlated btween Gensini score and Q-B/B-X,BNP.Conclusion The degree of coronary artery lesion was negatively correlated with cardiac function,and the worse the disease,the worse the heart function.