Correlation analysis of plasma N-terminal pro-brain natriuretic peptide, p-selectin and type 2 diabetes mellitus complicated with acute coronary syndrome / 解放军医学杂志

ABSTRACT

[Abstract] Objective To investigate the relationship between plasma N-terminal pro-brain natriuretic peptide (NT-pro-BNP), P-selectin (PS) and type 2 diabetes mellitus (T2DM) patients with acute coronary syndrome (ACS). Methods Two hundred and twenty-eight patients with chest pain, admitted in the Department of Cardiology of Langfang Traditional Chinese Medicine Hospital and the Affiliated Hospital of North China University of Science and Technology from July 2017 to April 2018, were selected in present study, including 32 patients with T2DM, 124 patients with ACS, and 72 patients with T2DM complicated with ACS (DA group). ELISA was performed to detect the levels of plasma NT-pro-BNP and PS, and venous blood was taken on an empty stomach to complete a general biochemical project. Based on the results of coronary angiography performed by using Judkins method, the Gensini score was used to evaluate the degree of coronary stenosis. The general clinical data of the 3 groups were compared, and logistic regression was performed to analyze the risk factors for ACS in patients with T2DM. Results No statistical difference existed in gender, history of hypertension, smoking, body mass index, age, and creatinine among the three groups; The levels of low-density lipoprotein cholesterol and triglyceride were higher in DA group [(3.16±0.98)mmol/L and (2.21±1.36)mmol/L] than in T2DM and ACS group [(2.83±0.91)mmol/L, (1.65±1.05)mmol/L and (2.84±0.92)mmol/L, (1.68±0.97)mmol/L] with significant difference (P<0.05). The left ventricular ejection fraction was lower in DA group (58.97±7.35)% than in T2DM and ACS groups [(63.48±7.37)% and (61.26±7.68)%, respectively] with statistically significant difference (P<0.01). The PS was higher in DA group (48.30±13.61)ng/L than in ACS group (38.87±9.12)ng/L, and in ACS group than in T2DM group (21.46±12.30)ng/L; The C-reactive protein was higher in DA group [(27.63±11.87)mg/L] than in ACS group (20.21±9.32)mg/L, and in ACS group than in T2DM group [(10.30±4.22)mg/L]; The NT-pro-BNP M(Q1, Q3) was higher in DA group [419(154, 1350)pg/ml] than in ACS group [120(43, 416)pg/ml], and in ACS group than in T2DM group [22(12, 54)pg/ml]; The Gensini scores was higher in DA group (138.39±88.31) than in ACS group (82.12±63.08), and in ACS group than in T2DM group (39.98±32.12), all the differences listed above were statistically significant (P<0.01). It had been confirmed by multivariate logistic regression analysis that the levels of PS and high-sensitivity C-reactive protein were the risk factors for ACS in patients with DM, their OR estimates were 1.138 (95%CI 1.089-1.990, P<0.01) and 1.656 (95%CI 1.189~2.307, P<0.01), respectively. Conclusion High levels of PS and high-sensitivity C-reactive protein are the independent risk factors for ACS in patients with T2DM. NT-pro-BNP was not associated with ACS in patients with T2DM.