Relationship between glycated albumin and extent of coronary lesions, GRACE score in patients with acute non-ST segmentelevation myocardial infarction

Abstract

Objective To investigate the relationship between glycated albumin(GA) and extent of coronary lesions, GRACE score in patients with acute non-ST segmentelevation myocardial infarction(NSTEMI). Methods A total of 226 NSTEMI patients who successfully underwent coronary angiography(CAG) were enrolled in the study.Groups: (1)According to GA level, the patients were divided into 3 groups: GA 17.0% group.(2)According to the extent of coronary lesions, the patients were divided into 2 groups: single or double branch lesion group, three and/or left main lesion group.(3)According to the GRACE score, the patients were divided into 3 groups: Low-risk GRACE score≤108 points group, Medium-risk 108 points 140 points group.The extent of coronary lesions was evaluated by Gensini score.The clinical characteristics and Gensini score, GRACE score of each group were compared.Pearson/Spearman correlation analysis and logistic regression were used to analyze the association of GA with the severity of coronary artery disease and GRACE score. Results With glycated albumin increasing, the Gensini score(56.51±38.57, 68.30±35.57, 77.38±36.52), GRACE score(139.43±29.96, 149.77±38.33, 170.75±27.52) increased significantly, and significant differences were found between groups(F=5.587, 16.006, P=0.004, 0.000). The ejection fraction(EF) of 3 groups were significantly decrease((58.30±13.95)%, (56.45±10.79)%, (53.06±12.51)%; F=3.126, P=0.046). Proportion of severe coronary lesions of 3 groups were increase significantly(59.5%(44/74), 68.2%(60/88), 87.5%(56/64), χ2=13.528, P=0.001). The level of GA in three and/or left main lesion group was higher than that in single or double branch lesion group((13.92±3.14)% vs.(16.80±3.58)%, t=-5.693, P=0.000). The level of GA in High-risk group was higher than that in Low-risk group((14.70±1.54)% vs.(16.63±4.02)%, t=6.512, P=0.002). Correlation analysis showed that the level of GA had significant positive correlation with Gensini score and GRACE score(r=0.309, 0.265; P=0.000, 0.000), while had a negative correlation with LVEF(r=-0.149, P=0.034). Logistic regression analysis indicated that GA was independent risk factors for severity of coronary artery disease in patients with NSTEMI who successfully underwent CAG(OR=1.441, 95% CI: 1.160-1.790, P=0.001). Conclusion GA level is increase in NSTEMI patients with severe coronary artery disease and risk stratification high.GA is the independent risk factors for severity of coronary artery disease in patients with NSTEMI; GA has significant correlation with dangerous degree in patients with NSTEMI. Key words: Acute myocardial infarction; Glycated albumin; Coronary lesions; GRACE score