Résumé
Objective To explore the predictive value of Tei index and plasma brain natriuretic peptide(BNP) on major adverse cardiovascular events(MACE) during long term follow up in the patients with anteriormyocardial infarction(MI).Methods A total of 238 patients with anterior MI were selected and divided into four groups according to the median of Tei index and BNP:G1 group(Tei≤0.66,BNP≤532.60 ng/mL,n=70),G2 group(Tei≤0.66,BNP＞532.60 ng/mL,n=51),G3 group(Tei＞0.66,BNP≤532.60 ng/mL,n=50) and G4 group(Tei＞0.66,BNP＞532.60 ng/mL,n=67).The follow up end was the MACE occurrence.Results There was a significant positive correlation between the Tei index and BNP(r=0.582,P=0.000).Tei entered the BNP regression equation(β=0.658,P＜0.05).The MACE-free survival rate had no statistical difference among 4 groups(x2 =9.975,P=0.019).The Cox regression analysis showed that Tei index and BNP were the independent predictive factors for MACE.Tei combined with BNP had stronger predictive value to MACE(AUC=0.781,95CI:0.721-0.841,P=0.000),its sensitivity was 72.52％ and specificity was 76.89％.Conclusion Tei combined with BNP has stronger predictive value for anterior MI during long term follow up.
Résumé
Objective: To study the relationship between insulin resistance (IR) and coronary collateral circulation in patients with impaired glucose tolerance (IGT). Methods: A total of 227 patients with coronary angiography (CAG) were studied. There were 131 patients with male gender and the average patient’s age was (53.2 ± 11.0) years. IR (HOMA2-IR) index was measured by HOMA2 method, the severity level of coronary stenosis was assessed by Gensini scoring system, collateral circulation condition was determined by Rentrop classiifcation. 187 IGT patients were divided into 4 groups: Rentrop 0 group,n=55, Rentrop 1 group,n=42, Rentrop 2 group,n=39 and Rentrop 3 group,n=51; in addition, Control group,n=40 patients with normal glucose tolerance and coronary stenosis<50%. Results: Compared with Control group, all patients in 4 Rentrop groups had increased 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while decreased fasting insulin (FINS), allP<0.05. Compared with Rentrop 3 group and Rentrop 2 group, the patients in Rentrop 1 group and Rentrop 0 group had elevated 2h-PBG, HbA1c, HOMA2-IR and Gensini score, while Rentrop 0 group had reduced FINS, allP<0.05. Multivariable regression analysis showed that HOMA2-IR index (R=0.518,P<0.05), HbA1c (R=1.916, P<0.05), 2h-PBG (R=2.130,P<0.05) and FINS (R=1.547,P<0.05) might be related to the severity of coronary stenosis. Binary regression analysis indicated that poor collateral circulation (the patients in Rentrop 0 group and Rentrop 1 group) was related to HOMA2-IR index (OR=1.679, 95% CI 1.101-2.558,P=0.016). Conclusion: HOMA2-IR index could be signiifcantly higher in patients with IGT combining chronic coronary occlusion. IR was the independent risk factor for the severity of coronary stenosis and coronary collateral formation.