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Objective:To investigate the clinical value of serum miR-208a in early differential diagnosis of acute coronary syndrome(ACS).Methods:One hundred ACS patients admitted to our department from January 2016 to January 2018 were randomly divided into the non-ST elevation myocardial infarction(NSTEMI)group(n=50)and the unstable angina(UA)group(n=50). Fifty healthy people during the same period were included as the control group(control). Serum levels of miR-208a, cardiac troponin-T(cTnT)and creatine kinase MB isoenzyme(CK-MB)were detected immediately, 4 h, 12 h and 24 h after admission and compared among the three groups of NSTEMI, UA and control.Receiver operating characteristic(ROC)curve was used to analyze the early diagnostic value of above serum indexes in NSTEMI and UA group, and the correlations of miR-208a level with cTnT and CK-MB were analyzed.Results:Serum miR-208a and cTnT levels had significant differences( P<0.05), while serum CK-MB level had no significant difference( P>0.05)among the NSTEMI and UA groups immediately after admission and the control group in the fasting state.There were significant differences in serum miR-208a, cTnT and CK-MB levels between NSTEMI group and UA group at different time points( P<0.05). After further multiple comparisons, the results showed that serum miR-208a and cTnT levels had statistical differences( P<0.05)and serum CK-MB level had no difference( P>0.05)between the NSTEMI group and the UA group immediately after admission.The above three biochemical indexes showed statistically significant differences between the NSTEMI group and the UA group at 4 h, 12 h and 24 h after admission( P<0.05). ROC curve analysis showed that miR-208a had a high diagnostic value in ACS(AUC>0.9, P=0.004), and the best diagnostic cut-off point was 9.278.The cTnT had a medium diagnostic value in ACS(0.7<AUC<0.9, P=0.013), and the diagnostic cut-off point was 5.147 μg/L.CK-MB had a low diagnostic value in ACS(0.5<AUC<0.7, P=0.031), and the diagnostic cut-off point was 82.716 u/l.Serum miR-208a level was positively correlated with cTnT level in ACS patients( P<0.05), and there was no correlation between serum miR-208a level and CK-MB level( P>0.05). Conclusions:Serum miR-208a has a higher value in early diagnosis of ACS than cTnT and CK-MB, and it has a better differentiation ability of NSTEMI than UA.
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Objective To investigate the correlation between myeloperoxidase(MPO)levels and adverse cardiac events in patients undergoing coronary stent implantation.Methods A total of 76 patients undergoing coronary stent implantation from January 2015 to June 2016 in the cardiac surgery department of our hospital were enrolled in this study.Serum levels of MPO,high sensitivity C-reactive protein(hs-CRP),and interleukin 6 (IL-6)were detected by enzyme-linked immunosorbent assays(ELISA).After a one-year follow-up,the receiver operating characteristic(ROC)curve was used to determine the predictive value of the difference in MPO before and after the operation(△MPO)on the long-term prognosis of patients after coronary stent implantation.The correlations of △MPO with the traditional risk factors for coronary heart disease and adverse cardiac events were analyzed using multi factor Logistic regression analysis.Results Serum levels of MPO,hs-CRP and IL 6 increased in patients after coronary stent implantation,compared with those before treatment (P ＜ 0.05).The results of ROC curve analysis showed that the area under the curve(AUC)value of serum △MPO was 0.786,the 95 ％ confidence interval was 0.471～ 1.000 and the predictive value of serum △MPO for adverse cardiac events was significant(P ＜0.05).There was a significant correlation between △MPO and age,and the incidence of adverse cardiac events increased with increased △MPO levels.Logistic regression analysis showed that serum △MPO levels could preliminarily diagnose the cardiovascular risk after coronary stent implantation and independently predict the occurrence of adverse cardiac events.Conclusions MPO levels in peripheral blood are notably elevated in patients after coronary stent implantation when compared with pre-treatment levels.Serum △MPO levels can preliminarily diagnose adverse cardiac events after coronary stent implantation and can be used as a marker to predict adverse cardiac events.
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Objective To compare the degree of coronary lesions in different types of heart failure with ischemic heart disease. Methods This retrospective analysis include 282 cases diagnosed as heart failure with ischemic heart disease in Zhengzhou People′s Hospital from January 2015 to May 2016. Based on LVEF and the level of BNP and NT-proBNP examination results ,282 cases were divided into HFmrEF(89 cases),HFrEF(109 cases) and HFpEF (84 cases). The clinical basic data ,cardiac color Doppler ultrasound and the difference of coronary artery lesions were compared. Results (1) HFpEF,HFmrEF and HFrEF groups gensini score were 30.45 ± 33.18,62.12 ± 41.25,86.72 ± 38.80. The differences are significant(P < 0.05). Pairwise comparison showed significant difference.(2)HFpEF,HFmrEF and HFrEF groups SYNTAX score were 11.77 ± 8.39,19.08 ± 8.39,26.41 ± 10.31. Compared with HFpEF group,the SYNTAX score of other groups are higher(P < 0.05). (3)The duration of disease ,LVEDD ,LVESD ,LVMI ,the number of vascular lesions was significantly higher in HFrEF group than those in other groups. (4) Multivariate correlation analysis suggested that SYNTAX scores were related to cardiac function classification,BNP,NT-proBNP and LVEF. Gensini integral is related to cardiac function classification ,BNP and NT-proBNP. Conclusions With the severity and complexity of coronary artery disease,the degree of heart failure is more serious. The complexity and severity of coronary artery disease is an important factor in heart failure in patients with ischemic heart disease.
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Objective To compare the degree of coronary lesions in different types of heart failure with ischemic heart disease. Methods This retrospective analysis include 282 cases diagnosed as heart failure with ischemic heart disease in Zhengzhou People′s Hospital from January 2015 to May 2016. Based on LVEF and the level of BNP and NT-proBNP examination results ,282 cases were divided into HFmrEF(89 cases),HFrEF(109 cases) and HFpEF (84 cases). The clinical basic data ,cardiac color Doppler ultrasound and the difference of coronary artery lesions were compared. Results (1) HFpEF,HFmrEF and HFrEF groups gensini score were 30.45 ± 33.18,62.12 ± 41.25,86.72 ± 38.80. The differences are significant(P < 0.05). Pairwise comparison showed significant difference.(2)HFpEF,HFmrEF and HFrEF groups SYNTAX score were 11.77 ± 8.39,19.08 ± 8.39,26.41 ± 10.31. Compared with HFpEF group,the SYNTAX score of other groups are higher(P < 0.05). (3)The duration of disease ,LVEDD ,LVESD ,LVMI ,the number of vascular lesions was significantly higher in HFrEF group than those in other groups. (4) Multivariate correlation analysis suggested that SYNTAX scores were related to cardiac function classification,BNP,NT-proBNP and LVEF. Gensini integral is related to cardiac function classification ,BNP and NT-proBNP. Conclusions With the severity and complexity of coronary artery disease,the degree of heart failure is more serious. The complexity and severity of coronary artery disease is an important factor in heart failure in patients with ischemic heart disease.
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AIM: To explore the significance of platelet activation, fibrinolytic activity and the changes of vasoactive mediators in acute myocardial infarction in rabbits and the intervention of amiodarone and metoprolol. METHODS: Fifty New Zealand white rabbits were randomly assigned to five groups, ten for each. Group Ⅰ: sham group, group Ⅱ: acute myocardial infarction(AMI) group, group Ⅲ: AMI and lidocaine group, group Ⅳ: AMI and amiodarone group, group Ⅴ: AMI and metoprolol group.The middle point of left ventricular coronary artery was ligated (groupⅡ,Ⅲ, Ⅳ and Ⅴ ) or a sham ligation(group Ⅰ). Four hours later, blood was collected for measuring plasma concentration of TXB 2, 6-Keto-PGF 1?, ET, NO, plasma activity of t-Pa and PAI.After that, the heart was taken out to evaluate the infarction size(IS). RESULTS: Plasma concentration of TXB 2, ET, NO and plasma activity of PAI were significantly higher in groupⅡ,Ⅲ, Ⅳ and Ⅴ than those in group Ⅰ(P0.05).Compared to group Ⅱ, plasma concentration of ET, NO and PAI activity were significantly decresed (P