Abstract:Aim To observe the relationship between serum lipoprotein(a) [Lp(a)], β2-microglobulin (β2-MG) and tumor necrosis factor-α (TNF-α) levels and degree of coronary artery lesion in patients with acute coronary syndrome (ACS), and to analyze their clinical significance. Methods A total of 87 patients diagnosed as ACS from June 2015 to June 2018 was collected, including 54 cases of unstable angina pectoris (UA) and 33 cases of acute myocardial infarction (AMI). Another 32 healthy person with basically matched age and gender in the same period were selected as control group. The levels of serum Lp(a), β2-MG and TNF-α were detected in all subjects, and the relationship between their levels and degree of coronary artery lesion was analyzed. Results Compared with control group, serum levels of Lp(a), β2-MG and TNF-α in ACS patients were increased significantly (P＜0.05), and serum levels of Lp(a) and TNF-α in AMI group were significantly higher than those in UA group (P＜0.05). With the increase of coronary artery lesion number and modified Gensini score grading, the serum levels of Lp(a), β2-MG and TNF-α in ACS patients were also increased (P＜0.05). Pearson correlation analysis showed that serum Lp(a), β2-MG and TNF-α levels were positively correlated with the number of coronary lesions and the modified Gensini score grading in ACS patients, respectively (P＜0.05). Logistic regression analysis showed that serum Lp(a), β2-MG and TNF-α levels were independent risk factors for ACS, in addition to the conventional influencing factors of ACS. Conclusions Serum levels of Lp(a), β2-MG and TNF-α in ACS patients are positively correlated with the degree of coronary artery lesions. With the disease aggravation of ACS patients, serum levels of Lp(a), β2-MG and TNF-α also rise.

Abstract:Aim To investigate the correlation between insulin resistance (IR) and degree of coronary artery lesion in patients with coronary heart disease (CHD) and impaired glucose tolerance (IGT). Methods 152 CHD patients with IGT, and 35 CHD patients with non-IGT (control group) were enrolled in this study. IR index (HOMA2-IR) was determined by HOMA2 method. Gensini score system was used to assess the degree of coronary artery stenosis quantitatively, and the type B2/C lesions were defined as complex lesions of the coronary artery. Taking the HOMA2-IR quartile as the cutoff point, 152 CHD patients with IGT were divided into 4 groups:the first quartile group (n＝38), the second quartile group (n＝38), the third quartile group (n＝38), the fourth quartile group (n＝38). Baseline data and the results of coronary angiography were compared among the five groups. Results 2 hour postprandial blood glucose (2hPBG), glycosylated hemoglobin A1 (HbA1c), fasting insulin and Gensini score increased gradually in the 5 groups, the difference was statistically significant (P＜0.01). Coronary multiple lesions and B2/C lesions in fourth quartile group were significantly higher than those in first quartile group and control group (P＜0.05). Correlation analysis showed that Gensini score was positively correlated with HOMA2-IR (r＝0.712, P＜0.001). Multivariable stepwise regression analysis showed that HOMA2-IR, HbA1c and 2hPBG were the independent risk factors affecting the degree of coronary artery stenosis. Logistic regression analysis showed that HOMA2-IR was an independent risk factor for multiple lesions and B2/C lesions. Conclusion IR is an important index reflecting the degree of coronary artery stenosis in patients with CHD and IGT.