The relationship of ACS patients complicated with diabetes with carotid artery IMT, serum IL-18,MMP-9 and plasma Fib / 安徽医科大学学报

ABSTRACT

Objective To analyze the characteristic of some important clinical indicators, including carotid artery intima-middle thickness ( IMT) , peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 con-centrations of acute coronary syndrome ( ACS) patients. On the other hand, to investigate the correlation among those indicators and major adverse cardiac events ( MACE) , and further to evaluate the value of those indicators in early prediction and prognosis judgement of ACS patients with diabetes( DM) in clinic. Methods This study en-rolled 120 ACS patients who had received coronary arteriography( CAG) examination. Among them, 60 cases had DM. Meanwhile, 60 cases who had DM were selected as DM group,60 cases of healthy people who received physi-cal health examination were selected as the control group. Carotid artery IMT was determined by color doppler ultra-sonography. The levels of Fib in peripheral blood were detected by solidification method. Immune turbidimetric method and ELISA were used to measure the concentrations of serum IL-18 and MMP-9 respectively. The CAG re-sults, complications and in-hospital mortality of ACS patients were also collected and analyzed. Results Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS pa-tients were significantly increased compared with healthy control(P<0. 01). A comparison of those clinical indica-tors of ACS patients between with DM group and without 2 diabetes group showed a significant increase in ACS pa-tients with DM group. Carotid artery IMT, plasma Fib, serum IL-18, MMP-9 and Gensini score in ACS patients were positively correlated. The incidence of multi-vessel diseases of coronary artery was more frequent in ACS pa-tients with DM versus without DM ( 61. 7%) , while one or two vessel diseases of coronary artery was much more common in ACS patients without DM (61. 7%) . The Gensini score of ACS patients with DM group was much high-er than that of ACS patients without DM group ( P<0. 01 );severe and extremely severe lesions occurred more fre-quently in ACS patients with DM group (73. 3%) ,while mild-to-moderate lesions occurred more frequently in ACS patients without DM group (56. 7%) . Peripheral blood Fib levels, serum IL-18 and MMP-9 concentrations were significantly higher in ACS patients with MACEs compared to ACS patients without MACEs. Peripheral blood Fib levels, serum IL-18 concentrations and serum MMP-9 concentrations of ACS diabetes mellitus extended the down-ward trend with the treatment time after standardized treatment show time-effect relationship. Conclusion Carotid artery IMT, peripheral blood Fib levels, serum IL-18 concentration and serum MMP-9 concentrations have great po-tential to become effective clinical indicators, which could be used to quantitatively predict coronary atherosclero-sis,and further to determine the risk degree and short-term prognosis of ACS patients with DM.