Degree Of Coronary Artery Lesions Research Articles

Association of the vitamin D metabolism gene polymorphism with the severity of coronary lesions assessed by SYNTAX score

This study aimed to determine the association of vitamin D serum blood levels and vitamin D gene polymorphism with the severity of coronary lesions in patients with stable coronary artery disease (CAD). Material and methods. 260 patients with stable CAD (average age was 58 years) were examined in the presented research. All patients were divided into two groups according to the SYNTAX score: low-risk patients with SYNTAX score ≤ 31 (n = 224) and high-risk patients with SYNTAX score > 31 (n = 36). For enzyme-linked immunosorbent assay and genetic analysis, peripheral blood was collected from the cubital vein into vacuum tubes containing coagulation activator and K3-EDTA, respectively. Serum blood level of 25-hydroxyvitamin D (DiaSource Diagnostics, Belgium) and 1,25-dihydroxyvitamin D (Immunodiagnostic Systems, Great Britain) were determined by enzyme-linked immunosorbent assay according to the manufacturers’ protocols. Genomic DNA was isolated by phenol-chloroform extraction method from whole blood. The quality and quantity of isolated DNA were assessed using NanoDrop spectrophotometer (Thermo Fisher Scientific, USA). Five polymorphic variants in the VDR (rs2228570 and rs73123) and GC (rs7041, rs1155563 and rs2298849) genes were selected for analysis. Genotyping was performed by real-time PCR in a 96-well plate with fluorescently labeled TaqMan probes. The quality of PCR was controlled by repeated genotyping of 10 % of the analyzed samples. Results. We found no statistically significant differences in serum blood level of the studied markers in patients from low-risk and high-risk groups. One polymorphic variant in the GC gene associated with the multiple coronary lesions (rs2298849) (odds ratio 2.26, 95 % confidence interval 1.28–3.99, p = 0.006) according to an additive inheritance model was identified. In addition, we determined the association between low serum blood level of 1,25-dihydroxyvitamin D in patients with CAD with multiple lesions of the coronary vascular system with A/A – A/G genotypes of the rs2228570 polymorphism in the VDR gene, A/A genotype of the rs7041 polymorphism and A/A genotype of the rs2298849 polymorphism in the GC gene. Conclusions. Allelic variants in the vitamin D metabolism genes are associated with the degree of coronary artery lesions assessed by the SYNTAX score in patients with stable CAD. Also, serum blood level of the active form of vitamin D (1,25-dihydroxyvitamin D) is less in carriers of homozygous genotypes for the major alleles of the VDR and GC genes.

The evaluation value of atherogenic index of plasma and high-sensitivity C-reactive protein for the degree of coronary artery lesion in premature coronary artery disease

BackgroundPremature coronary artery disease (PCAD) is prevailing. We aimed to investigate the evaluation value of atherogenic index of plasma (AIP) and high-sensitivity C-reactive protein (hs-CRP) for the occurrence and severity of coronary artery lesion in PCAD patients.MethodsPCAD (PACD group)/non-PCAD (control group) patients were enrolled. The coronary artery lesion degree was evaluated using Gensini score (GS). PCAD patients were allocated into the low/medium/high GS groups, with general clinical baseline data analyzed. Plasma hs-CRP/AIP levels were compared in PCAD patients with different disease degree. Correlations between plasma hs-CRP/AIP with Gensini score, independent risk factors affecting the occurrence of PCAD, and the predictive value of hs-CRP/AIP/their combination for the occurrence and degree of PCAD were evaluated by Spearman correlation analysis/Logistic multivariate regression/receiver operating characteristic (ROC) curve. The differences in the area under the curve (AUC) were compared using MedCalc-Comparison of ROC curves.ResultsPlasma hs-CRP/AIP levels in the PCAD group were increased. Plasma hs-CRP/AIP levels varied significantly among PCAD patients with different disease degree. Plasma hs-CRP/AIP levels were markedly positively correlated with the Gensini score. Smoking history/homocysteine/fasting blood-glucose/hs-CRP/AIP were all independent risk factors affecting PCAD occurrence. The AUC of hs-CRP and AIP combination predicting the occurrence of PCAD was 0.950 (90.80% sensitivity/93.33% specificity). hs-CRP/AIP combination assisted in predicting the disease degree in PCAD patients.ConclusionsAIP and hs-CRP are independent risk factors for the occurrence of PCAD, and their combination has high predictive value for PCAD occurrence and disease degree, which are both positively correlated with coronary artery lesion degree.

Analysis of long non-coding RNA RMRP in the diagnosis and prognosis of coronary artery disease

BackgroundLong non-coding RNAs (lncRNAs) are abundant and closely related to the occurrence and development of human diseases. LncRNAs are known to play a key role in many cardiovascular diseases. The purpose of this study was to investigate the effect of the RNA component of mitochondrial RNA-processing endoribonuclease (RMRP) on the degree of coronary artery lesions and prognosis in patients with coronary artery disease (CAD).MethodsPatients who underwent coronary angiography (CAG) and dynamical-single photon emission computed tomography (D-SPECT) were selected as study subjects, and the results of CAG were reviewed, and the patients were grouped according to SYNTAX score. Evaluate the factors affecting SYNTAX scores. The follow-up analysis was conducted, and the endpoint events were major adverse cardiovascular events (MACEs). Kaplan–Meier method was used to estimate the survival rate, and multivariate Cox regression was used to analyze the relationship between RMRP and MACEs.ResultsThe expression level of serum RMRP in patients with CAD was significantly higher than that in healthy people. Multivariate Logistic regression analysis showed that age, low-density lipoprotein cholesterol (LDL-C), RMRP and rest left ventricular ejection fraction (LVEF) were independent factors that affected SYNTAX scores. There were 19 cases of MACEs in the high RMRP group and 9 cases in the low RMRP group, and there was a significant difference in the MACE free survival curve between the two groups. Multivariate Cox regression analysis showed that age, SYNTAX score, rest LVEF and RMRP were risk factors for MACEs.ConclusionsSerum RMRP is a key factor affecting the degree of coronary artery disease and prognosis in CAD patients.

Intramural coronary artery and myocardial pathology in captive tigers (Panthera tigris) and African lions (Panthera leo).

There is limited published data regarding cardiovascular disease in nondomestic felid populations. To address this knowledge gap, necropsy cases of tigers and lions with representative myocardial samples submitted to a diagnostic laboratory were histologically assessed with hematoxylin and eosin and Sirius red stains. A total of 32 submissions (15 tigers, 17 lions) were identified in a 4-year period. All tigers and lions had some degree of coronary artery lesions in the left ventricle and/or interventricular septum. Major findings included moderate to marked arteriosclerosis in 8 tigers (53%) and 4 lions (24%) and moderate to marked perivascular fibrosis in 10 tigers (67%) and 9 lions (53%). Moreover, 10 tigers (67%) and 8 lions (47%) had coronary artery lesions with variable degrees of perivascular cardiomyocyte degeneration and/or loss. To our knowledge, this is the first report describing coronary artery pathology in captive tigers and lions.

Predicting Endothelium-Dependent Diastolic Function (FMD) and Its Correlation with the Degree of Coronary Artery Disease (CAD) and Plaque Vulnerability for Cardiovascular Events.

This study aims to investigate the correlation between vascular endothelium-dependent diastolic function (FMD) and the degree of coronary artery disease (CAD), plaque vulnerability, and its predictive value for cardiovascular events. Initially, patients (n=100) who were admitted from January 2020 to January 2021 and intended to undergo percutaneous coronary intervention (PCI) were selected. Further, FMD in all patients was determined before the procedure and divided into a high-FMD group (≥4.2%) and a low-FMD group (<4.2%). Further, the data of two groups, including general information, coronary artery lesions, and plaque fibrous cap, were compared. Finally, the relationship between FMD and the degree of coronary artery lesions and plaque vulnerability was analyzed. No significant differences were observed concerning general information, number of coronary arteries-associated branches, lesion type, involvement of the left main stem (LM), the proportion of chronic occluded lesions (CTO), and lipid pool angle between the low-FMD group and the high-FMD group (P > 0.05). Nevertheless, the degree of stenosis of the lesions in the low-FMD group was significantly higher than in the high-FMD group (P < 0.05). In addition, the thickness of the fibrous cap was considerably lower than that in the high-FMD group (P < 0.05). Moreover, the incidence rate of TCFA was significantly higher than the high-FMD group (P < 0.05). The correlation analysis showed that FMD was significantly negatively correlated with the degree of coronary artery lesion stenosis and TCFA (P < 0.05) and positively correlated with the fibrous cap thickness (P < 0.05). Overall, a negative correlation between FMD and the degree of coronary stenosis, plaque vulnerability, and a high predictive value for post-PCI cardiovascular events suggested that FMD could be a critical diagnostic marker for CAD.

Relationship between TyG index and the degree of coronary artery lesions in patients with H-type hypertension

BackgroundThe TyG index, a prominent metric for assessing insulin resistance, has gained traction as a prognostic tool for cardiovascular disease. Nevertheless, the understanding of the prognostic significance of the extent of coronary artery stenosis in individuals afflicted with H-type hypertension remains limited.MethodsA retrospective study was conducted at Wuhan Third Hospital, including a cohort of 320 inpatients who were diagnosed with hypertension in combination with coronary artery disease. The study period spanned from January 1, 2021, to February 1, 2023. The study cohort was stratified based on the severity of stenosis into three distinct groups: low stenosis, medium stenosis, and high stenosis, as determined by the Gensini score derived from coronary angiography findings. The present study aimed to investigate the association between the severity of coronary stenosis and the number of lesion branches, utilizing the TyG index as a testing indicator. The predictive ability of TyG for coronary lesion severity was assessed using logistic regression analysis.ResultsThe results of our study indicate a positive correlation between elevated levels of TyG and an increased susceptibility to severe stenosis in individuals diagnosed with H-type hypertension. Upon careful consideration of potential confounding variables, it has been observed that the TyG index exhibits a robust association with the likelihood of severe stenosis in individuals with H-type hypertension (odds ratio [OR] = 4000, 95% confidence interval CI 2.411–6.635, p = 0.0001), as well as the prevalence of multivessel disease (OR = 1.862, 95% CI 1.036–3.348, p < 0.0001). The TyG index demonstrated superior predictive ability for severe coronary stenosis in patients with H-type hypertension compared to those without H-type hypertension (area under the curve [AUC] = 0.888, 95% confidence interval CI 0.838–0.939, p < 0.0001, versus AUC = 0.615, 95% CI 0.494–0.737, p < 0.05).ConclusionThe TyG index is an independent risk factor for the degree of coronary stenosis and a better predictor in patients with H-type hypertension combined with coronary artery disease.

Relationship between ambulatory arterial stiffness index and the severity of angiographic atherosclerosis in patients with H-type hypertension and coronary artery disease

ABSTRACT Objective To investigate coronary artery disease (CAD) and its correlation with the ambulatory arterial stiffness index (AASI) in patients with H-type hypertension (essential hypertension combined with hyper-homocysteinemia) and coronary heart disease (CHD). Methods Patients with essential hypertension and CHD who were undergoing coronary angiography were enrolled. The general clinical data, biochemical indicators, ambulatory blood pressure monitoring results and coronary angiography results of the selected patients were collected, and the AASI and Gensini scores were calculated. According to homocysteine (Hcy) levels, the patients were divided into two groups: a study group and a control group. The differences in general clinical data, biochemical indexes, AASI scores and degree of coronary artery lesions between the two groups were compared. The correlation between the AASI and the Gensini score and the relationship between the AASI and the Gensini score of CAD and various factors were analyzed. Results Compared with the control group, the Hcy level in the study group was significantly increased (8.16 ± 2.33 vs 19.20 ± 2.36, P = .001). The 24-h diastolic blood pressure (DBP) in the study group was significantly lower than that in the control group (76.38 ± 9.33 vs 79.91 ± 9.25, P = .002), and the AASI was significantly higher than in the control group (0.62 ± 0.81 vs 0.420 ± 0.70, P = .001). The number of patients having coronary stenoses with a Gensini score of ≤ 38 was significantly lower in the study group than in the control group (21.3% vs 49.4%, P < .001). The number of patients with a Gensini score of ≥ 51 in the study group was significantly higher than in the control group (22.0% vs 18.8%, P < .001). There was a significant positive correlation between the AASI and the Gensini score in the study group (R = 0.732, P < .001). Hypertension duration (β = 0.168), diabetes history (β = 0.236), 24-h SBP (β = 0.122), 24-h DBP (β = -0.131), low-density lipoprotein cholesterol (β = 0.134) and Hcy (β = 0.233) were the influencing factors for AASI (P < .05). Both Hcy * AASI (β = 0.356) and Hcy × 24-h HR (β = 0.331) had a synergistic effect on the Gensini score (P = .017), with Hcy * AASI having a more significant effect on the Gensini score (P < .001). Conclusion The AASI was significantly increased in patients with H-type hypertension and CHD, which was associated with the severity of CAD. Therefore, Hcy levels and the AASI have a synergistic effect when evaluating the severity of CAD in patients with hypertensive CHD.

Studying variable in serum apolipoprotein B levels in damaged coronary artery patients

ABSTRACT Introduction: Atherosclerosis is the most important cause of increasing coronary heart disease. When cholesterol LDL-C levels are low, an increase in Apo B is associated with 60% of the cardiovascular risk factors. This study find out the association between serum Apolipoprotein B levels with the degree of coronary artery lesions Methods: The study consists of 110 patients who were diagnosed with a meaningful damaged coronary artery through angiography at Hoan My Da Nang hospital, from March 2018 to September 2019. Research method: cross-sectional description. Results: The average value of serum Apo B in group 1 was 133.67 ± 17.56 mg/dl, and in group 2 it was 113.92 ± 16.78 mg/dl. The difference is statistically significant, p &lt; 0.01. Cardiovascular risk factors in the study did not have a meaningful effect on serum Apo B levels. Dyslipidemia does not have a strong correlation with serum Apo B levels. Thereby, it is possible to recognize serum Apo B as an independent indicator along with other cardiovascular risk factors. Serum Apo B levels increase linearly according to the number of damaged coronary artery branches. There is a proportional correlation between serum Apo B levels and the degree of coronary artery lesions (r = 0.48, p &lt; 0.01). Conclusion: Apo B is associated with the degree of coronary artery lesions.

White blood cell count combined with LDL cholesterol as a valuable biomarker for coronary artery disease.

Inflammation and dyslipidemia are important pathophysiological bases for the occurrence and development of coronary artery disease (CAD); however, combination of these two entities is rarely used to diagnose CAD and its severity. Our aim was to determine whether the combination of white blood cell count (WBCC) and LDL cholesterol (LDL-C) can serve as a biomarker for CAD. We enrolled 518 registered patients and measured serum WBCC and LDL-C on admission. The clinical data were collected, and the Gensini score was used to assess the severity of coronary atherosclerosis. WBCC and LDL-C levels in the CAD group were higher than in the control group ( P < 0.01). Spearman correlation analysis showed that WBCC combined with LDL-C was positively correlated with the Gensini score ( r = 0.708, P < 0.01) and the number of coronary artery lesions ( r = 0.721, P < 0.01). Receiver operating characteristic curve analysis revealed that WBCC combined with LDL-C had a higher predictive value for CAD, severe CAD, and three-vessel CAD [area under the curve (AUC) values were 0.909, 0.867, and 0.811, respectively] than WBCC (AUC values were 0.814, 0.753, 0.716, respectively) and LDL-C (AUC values were 0.779, 0.806, 0.715, respectively) alone (all P < 0.05). WBCC combined with LDL-C is correlated with the degree of coronary artery lesion. It had high sensitivity and specificity in the diagnosis of CAD, severe CAD, and three-vessel CAD.

Medical Fuzzy-Expert System for Assessment of the Degree of Anatomical Lesion of Coronary Arteries.

Today, cardiovascular diseases cause 47% of all deaths among the European population, which is 4 million cases every year. In Ukraine, CAD accounts for 65% of the mortality rate from circulatory system diseases of the able-bodied population and is the main cause of disability. The aim of this study is to develop a medical expert system based on fuzzy sets for assessing the degree of coronary artery lesions in patients with coronary artery disease. The method of using fuzzy sets for the implementation of an information expert system for solving the problems of medical diagnostics, in particular, when assessing the degree of anatomical lesion of the coronary arteries in patients with various forms of coronary artery disease, has been developed. The paper analyses the main areas of application of mathematical methods in medical diagnostics, and formulates the principles of diagnostics, based on fuzzy logic. The developed models and algorithms of medical diagnostics are based on the ideas and principles of artificial intelligence and knowledge engineering, the theory of experiment planning, the theory of fuzzy sets and linguistic variables. The expert system is tested on real data. Through research and comparison of the results of experts and the created medical expert system, the reliability of supporting the correct decision making of the medical expert system based on fuzzy sets for assessing the degree of anatomical lesion of the coronary arteries in patients with various forms of coronary artery disease with the assessment of experts was 95%, which shows the high efficiency of decision making. The practical value of the work lies in the possibility of using the automated expert system for the solution of the problems of medical diagnosis based on fuzzy logic for assessing the degree of anatomical lesion of the coronary arteries in patients with various forms of coronary artery disease. The proposed concept must be further validated for inter-rater consistency and reliability. Thus, it is promising to create expert medical systems based on fuzzy sets for assessing the degree of disease pathology.

Peculiarities of heart rhythm disorders in patients with myocardial infarction without elevation of ST segment depending on the degree of coronary artery lesions

Summary. The prevalence of myocardial infarction and its leading role in the structure of overall and cardiovascular mortality encourages the search for predictors of complicated course of disease and the search for optimal means to prevent adverse events. The aim of the study – to establish features of cardiac arrhythmias in patients with myocardial infarction without ST-segment elevation depending on the degree of coronary artery lesions. Materials and Methods. The study involved 156 patients with NSTEMI aged 38 to 80 years. All patients were examined according to the current treatment protocol for patients with acute coronary syndrome without ST segment elevation and daily Holter ECG monitoring was performed for 3-5 days after hospitalization. Results. It was found that the degree of coronary artery lesions is positively correlated with the likelihood of severe adverse ventricular arrhythmias and episodes of silent myocardial ischemia in the early period. Conclusions. By determining the total score of coronary artery disease, it is possible to stratify the adverse course of NSTEMI, in particular, the occurrence of fatal ventricular arrhythmias in the early period.

ASSESSMENT OF TYPES OF MYOCARDIAL DIASTOLIC DYSFUNCTION DEPENDING ON THE DEGREE OF CORONARY ARTERY LESION IN PATIENTS WITH NSTEMI.

The aim: To evaluate the types of myocardial diastolic dysfunction depending on the degree of coronary artery lesion in patients with NSTEMI. Materials and methods: We examined 200 patients with NSTEMI aged 38 to 80 years, who were urgently hospitalized in the Vinnytsya Regional Clinical Center of Cardiovascular Pathology. All patients underwent echocardiography examination from 3 to 5 day of hospitalization after coronary angiography. Results: We established that there were no significant gender and age differences in the types of diastolic dysfunction. However, we found that with an increase in the degree of damage to the coronary arteries and an increase in the number of affected arteries, the degree of severity of myocardial diastolic dysfunction increases and the probability of occurrence of more unfavorable types of dysfunction increases. Conclusions: Determining the types of myocardial diastolic dysfunction in the early period of NSTEMI makes it possible to predict unfavorable variants of the course of the disease and prevent possible complications.

Prediction of coronary atherosclerosis in young patients with coronary artery disease using a non-invasive biomarker

Aim . To develop a combined biomarker for non-invasive diagnostics of the severity of coronary artery (CA) atherosclerosis in patients with coronary artery disease (CAD) and in those without clinical manifestations of atherosclerosis under 50 years of age using structural and functional parameters of large arteries and the lipid profile. Material and methods . A total of 92 patients with CAD and 28 healthy ones were included. Depending on the results of coronary angiography, patients with CAD were divided into 3 groups: without hemodynamically significant stenosis (HSS) (HSS 1&lt;50% , n=30), with HSS of one CA (HSS 1&gt;50% , n=37), with HSS of 2 and more CA (HSS 2&gt;50% , n=25). The subjects underwent a biochemical blood test, carotid duplex ultrasound, volumetric sphygmography. Results . In individuals with HSS1&lt;50%, lipid metabolism disorders were diagnosed in 63,3% (n=19), in HSS 1&gt;50% group — 78,4% (n=29), in HSS2&gt;50% group — 92% of cases (n=23) (p 1-3 &lt;0,05). Carotid intima-media thickness exceeding the threshold level was found in 40% of patients with HSS 1&lt;50% , in 51% of patients with HSS 1&gt;50% and 64% of patients with HSS 2&gt;50% (p 1-3 &lt;0,05). According to the results of volumetric sphygmography, the severity of CA atherosclerosis was associated with a higher pulse wave velocity and L-/CAVI 1 . At the next stage, a complex parameter for predicting coronary atherosclerosis (CA biomarker) was developed, including sex, structural and functional indicators of the arteries (intima-media thickness, в-stiffness index, L-/CAVI 1 ) and biochemical parameters (total cholesterol, triglycerides, low density lipoproteins). In healthy people, the level of CA biomarker was 2,7 (95% CI, 2,3-3,9); in patients with CAD with any degree of CA lesion — 6,4 (95% CI, 5,2-9,6). The CA biomarker threshold of 5 points with a sensitivity of 87,5% and a specificity of 90,5% was determined as the optimal cut-off point; area under the curve — 0,965 (95% CI, 0,943-0,987) (p&lt;0,0001). Conclusion . In patients with CAD, the presence and degree of coronary atherosclerosis are associated with the deterioration of most structural and functional artery parameters. The developed complex CA biomarker is of interest for non-in-vasive screening of preclinical CA atherosclerosis in patients with a low relative risk.

Cardiac CT scanning in coronary artery disease: Epicardial fat volume and its correlation with coronary artery lesions and left ventricular function.

Coronary artery disease (CAD) is a major and common disease that poses a threat to human health. Recent studies suggested that epicardial fat may have an important role in the pathogenesis of CAD. Therefore, the association between epicardial fat volume (EFV) and left ventricular function with CAD was investigated in the present study. A total of 61 patients with suspected CAD who underwent CT scanning were enrolled. Baseline data, parameters of left heart function and EFV of the subjects were collected and analyzed. The degree of coronary artery lesions was assessed using the Gensini score. Pearson's correlation analysis and a logistic regression model were applied to assess the association between EFV and risk factors for CAD, the Gensini score and left ventricular function index. A total of 29 female and 32 male subjects with a median age of 63 years were enrolled. The median body mass index (BMI) of the subjects was 23.37 kg/m2 and the median EFV was 86.41 cm3. It was revealed that risk factors of CAD, specially hypertension, diabetes mellitus, dyslipidemia, history of myocardial infarction and smoking, had no significant association with the EFV (P>0.05); however, the EFV was significantly positively correlated with the BMI (r=0.479, P<0.0001), interventricular septal thickness (r=0.436, P=0.004), left ventricular posterior wall thickness (r=0.350, P=0.0058), left ventricular end diastolic diameter (r=0.265, P=0.0388), left ventricular mass (r=0.445, P=0.0003) and left ventricular mass index (r=0.371, P=0.0035). However, no correlation was identified between the EFV and the Gensini score (r=0.131, P=0.3137). In conclusion, the EFV measured by cardiac CT scanning was positively correlated with the BMI and left ventricular function, but was not associated with the presence of CAD according to the Gensini scores.

Nghiên cứu mối liên quan giữa nồng độ ima (Ischemia modified albumin) và mức độ tổn thương động mạch vành ở bệnh nhân hội chứng vành cấp

RESEARCH THE CORRELATION BETWEEN IMA CONCENTRATION AND DEGREE OF CORONARY ARTERY LESIONS IN PATIENTS WITH ACUTE CORONARY SYNDROME Introduction: Coronary artery lesions were the main cause of ACS, the character of coronary artery lesion and how is IMA concentrations correlated with degree of coronary artery lesion in acute coronary syndrome? Objective: Survey character of coronary artery lesions in patients with acute coronary syndrome through the results of angiography and correlation between the concentration of IMA and degree of coronary artery lesions in patients with acute coronary syndrome. Subject and Method: 130 patients at the Cardiology Center-Hue Central Hospital are diagnosed acute coronary syndrome according to the Fourth universal definition of myocardial infarction 2018. In which 103 patients were taken angiography and evaluated the coronary artery lesions follow GENSINI scale. Result: Research conducted on 130 patients, including 85 males and 45 females with the proportion of male: female is 1.89, average age: 65.7 ± 12.3years old. There are 91.3% of patients with coronary artery lesions higher than coronary artery non lesions (p &lt;0.001). Injury of one branch accounted for 35,9%, two branch accounted for 34.0% and three branch injuries accounted for 21.4%.. There are 79.6% in LAD injury and 58.3% in RCA, accounting for 41.7% in LCx. The lesions stenosis that more than 75% is accounted for the highest percentage 70.59%. GENSINI score average is 27.80 ± 25.92 and median score is 21 points. There is no correlation between the concentration of IMA and the branching coronary lesions with r = - 0,046, p &gt; 0.05. There is no correlation between the concentration of IMA and GENSINI scores with r = - 0,064, p&gt; 0,05. Conclusions: LAD lesions accounted for the highest percentage, lesions more than one coronary artery branch also high percentage and severe coronary stenosis is highest proportion in acute coronary syndrome. There is no correlation between the IMA concentration and the number of branching coronary lesions, as well as GENSINI scores. Key words: IMA, Coronay artery lesions, ACS.

Fasting Plasma Glucose and Coronary Heart Disease in a Rural Population of North Henan, China.

Even in individuals without diabetes, the incidence of coronary heart disease (CHD) increases with the rise in fasting plasma glucose (FPG); however, the threshold of FPG for CHD in rural areas of China is unclear. We retrospectively examined 2,987 people. Coronary angiography records were used to determine the presence of CHD as well as its severity. Risk factors for CHD and the relationship between different levels of FPG and CHD were analyzed. After adjusting for age, hypertension, dyslipidemia, smoking, drinking, chronic kidney disease, and previous ischemic stroke, the incidence of CHD in nondiabetic women began to increase when FPG exceeded 5.2 mmol/L (odds ratio (OR) = 1.438, 95% confidence interval (CI) = 1.099–1.880, p=0.008), and the degree of coronary artery lesions also became more severe (OR = 1.406, 95% CI = 1.107–1.788, p=0.005). However, no such correlations were found in nondiabetic men. In conclusion, among the nondiabetic women in rural areas of northern Henan, both the incidence of CHD and the severity of lesions increased when FPG levels were greater than 5.2 mmol/L, while no significant correlation between FPG and CHD was observed in diabetes-free men.

Comparative characteristics of coronary artery damage in different degree of ischemic mitral regurgitation

Introduction.Despite an active study of the problem of ischemic mitral regurgitation, studies of its connections with the degree and localization of coronary artery lesions are contradictory.Objective.Study the features of coronary artery lesions according to coronary angiography in patients with ischemic heart disease and ischemic mitral regurgitation and the connections between the severity of coronary artery lesions and the degree of ischemic mitral regurgitation.Material andmethods.A retrospective analysis of the results of the examination of 86 patients with various forms of ischemic heart disease in combination with ischemic mitral regurgitation, operated in the department of cardiovascular surgery of the P.V. Mandryka Central Military Hospital. Results. 89,5 % of patients showed multifocal atherosclerotic coronary artery lesions, requiring direct myocardial revascularization; the predominant type of coronary blood supply was right (82,6 %); the average number of affected main coronary arteries was 2,2±1,1, the average total degree of coronary artery lesion was 42,3±25,1 %.Conclusion.1. The connections between the degree of ischemic mitral regurgitation and the severity and localization of coronary artery lesions was not revealed. 2. The degree of ischemic mitral regurgitation determined primarily by the progression of ischemic remodeling of the left ventricle. 3. Coronary angiography data cannot be a criterion for determining the degree of ischemic mitral regurgitation, however, they are necessary for determining the surgical tactics of direct myocardial revascularization.

Research on the effects of CPAP for OSA combined CHD long-term prognosis

Objective:To investigate the effects of CPAP for obstructive sleep apnea（OSA） combined CHD（coronary heart disease） long-term prognosis. Method:One hundred and twenty cases of OSA combind CHD in gansu province people's hospital sleep center were randomly divided into two groups according to apnea hypopnea index（AHI）, group A（light, medium OSA and CHD） 60 cases, group B（severe OSA and CHD） 60 cases. Contrast analysis and comparison between two groups PSG（Polysomnography） parameters, and the differences between the degree of coronary artery lesions and CPAP therapy effect on coronary long-term prognosis. Result:Compared group B with A, AHI, BMI, LSaO2, Epworth sleepiness scale（ESS） score, the amino acid homocysteine, the prevalence of hypertension, type 2 diabetes, the prevalence of acute myocardial infarction（ami） and vascular lesions and SYNTAX score increased significantly（P<0.05）. The ejection fraction decreased significantly（P<0.05）. The BNP（Brain natriuretic peptide） and cTNT（cardiac troponin, cTn） concentration there was no significant difference between the two groups（P>0.05）. CPAP treatment（30.0±4.2） months later, Group B: CAPA + conventional treatment group, compared with the simple routine LSaO2, ejection fraction increased significantly（P<0.05）, AHI, cardiovascular adverse events, vascular lesions, SYNTAX score, the BNP and TNT concentration significantly reduced（P<0.05）; Group A: AHI, decreased significantly（P<0.05）, LSaO2increased significantly（P<0.05）, ejection fraction, cardiovascular adverse events, vascular lesions, SYNTAX score, there was no significant difference between the BNP and TNT concentration; Survival analysis showed that: Group A CPAP+conventional treatment group cumulative survival rate higher than the conventional treatment group, but there was no statistically significant difference（P=0.260）. Group B: CPAP+conventional treatment group total survival rate was significantly higher than that of the conventional treatment group（P<0.001）; Conclusion:With the increase of the severity of OSA, OSA merge CHD coronary artery pathological changes degree aggravating, CPAP therapeutic benefit the long-term prognosis of CHD.

Relationship between serum levels of osteoproteins, inflammatory cytokines and coronary heart disease and disease severity

To explore the relationship between serum levels of osteoprotein (OPG), soluble nuclear factor-κB receptor activator ligand (sRANKL), inflammatory factors and coronary heart disease (CHD) and its severity. The patients who underwent coronary angiography (CAG) due to chest pain admitted to department of cardiology of Tianjin Chest Hospital from April 2017 to December 2018 were enrolled, and they were divided into CHD group and non-CHD group according to the CAG results. The gender, age, history of hypertension, smoking history, diabetes, the levels of cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein AI (apoAI), apolipoprotein B (apoB), lipoprotein (a) [Lp (a)], MB isoenzyme of creatine kinase (CK-MB) and other clinical data of patients were collected. The serum levels of OPG, sRANKL, matrix metalloproteinase-9 (MMP-9), monocyte chemotactic protein-1 (MCP-1), insulin-like growth factor-1 (IGF-1) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA). According to the results of CAG, the patients with CHD were divided into single-, double-, triple-branch coronary artery lesion groups, and the relationship between the levels of serum OPG, sRANKL, inflammatory factors and the degree of coronary artery lesions was observed. Multivariate Logistic regression was used to analyze the risk factors of CHD, and receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of main risk factors for CHD. A total of 472 patients were enrolled in the final analysis during the study period, including 264 patients in the CHD group, 208 patients in the non-CHD group, 79 patients in the CHD group with single-branch disease, 75 patients with double-branch disease, and 110 patients with three-branch disease. (1) Compared with the non-CHD group, the CHD group had more older male patients, as well as higher proportion of hypertension and diabetes, the levels of serum Lp (a) and CK-MB were significantly increased, and the levels of serum HDL-C and apoAI were significantly lowered. There was no statistically significant difference in serum TC, LDL-C, or apoB between the two groups. The levels of serum OPG, MMP-9, MCP-1, IGF-1 and IL-6 in the CHD group were significantly higher than those in the non-CHD group [OPG (μg/L): 1.79±0.50 vs. 1.50±0.30, MMP-9 (μg/L): 57.91 (33.50, 130.46) vs. 38.33 (29.43, 109.78), MCP-1 (μg/L): 298.30 (207.96, 537.16) vs. 252.73 (165.22, 476.01), IGF-1 (μg/L): 734.03±486.11 vs. 217.75±126.45, IL-6 (ng/L): 64.76±40.25 vs. 48.60±15.80, all P < 0.05], and the levels of serum sRANKL was significantly lower than that in the non-CHD group (ng/L: 344.31±122.14 vs. 378.74±109.27, P < 0.05). (2) The serum OPG level showed a slight upward tendency with the increase in the number of coronary artery lesions, and the sRANKL level showed a slight downward tendency [OPG (μg/L) in the single-, double-, triple-branch coronary artery lesion groups was 1.74±0.49, 1.76±0.50, 1.85±0.52, and sRANKL (ng/L) was 354.96±116.64, 340.05±124.24, 339.57±125.03, respectively) without statistically significant differences (all P > 0.05). The levels of IGF-1 and IL-6 were increased with the number of coronary artery lesions [IGF-1 (μg/L) in the single-, double- and triple-branch coronary artery lesions groups was 372.13±258.42, 676.06±350.29, 1 033.47±468.06, and IL-6 (ng/L) was 48.87±16.72, 65.36±18.84, 75.76±22.72, respectively], and the differences among different lesion groups were statistically significant (all P < 0.01). Correlation analysis showed that IGF-1 level was significantly positively correlated with the number of coronary artery lesions (r = 0.612, P < 0.01), while IL-6 was not correlated with the number of coronary artery lesions (r = 0.185, P > 0.05). (3) Multivariate Logistic regression analysis showed that elevated serum OPG and IGF-1 levels were risk factors for CHD [OPG: odds ratio (OR) = 1.995, 95% confidence interval (95%CI) = 1.936-2.067, P = 0.012; IGF-1: OR = 1.009, 95%CI = 1.004-1.015, P = 0.001]. (4) ROC curve analysis showed that the area under ROC curve (AUC) of OPG and IGF-1 was 0.716 and 0.867, respectively. When the cut-off value of OPG was 1.13 μg/L, the sensitivity was 81.7%, the specificity was 58.1%; when the cut-off value of sRANKL was 401.20 μg/L, the sensitivity was 69.7%, the specificity was 95.7%. CHD was associated with increased in OPG, related inflammatory cytokines including MMP-9, MCP-1, IGF-1 and IL-6, and decreased in sRANKL. The level of IGF-1 was positively correlated with the severity of CHD. The serum levels of OPG and IGF-1 were risk factors for CHD, which had good predictive value for CHD.

Research on the changes and significance of serum RBP4 level in patients with senior coronary heart disease accompanying diabetes mellitus

Objective: To explore the significance of serum Retinol binding protein 4 (RBP4) and its relationship with coronary artery lesion in patients with senior coronary heart disease accompanying T2DM by determining the level of serum RBP4 and Gensini score.Methods: 30 cases of patients who were 60 years old above with coronary heart disease accompanying T2DM were selected and included in the experimental group, and 30 cases of patients of 60 years old above with coronary heart disease alone were included in the control group. Both groups of patients were given CAG examinations. In addition, Gensini score was calculated according to different degrees and parts of coronary artery lesion. It was required to record each patient’s age, gender, fasting blood glucose (FPG), triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c) and other laboratory examination indexes. ELISA was used to detect the level of serum RBP4 in each group, and statistical analysis was performed to the data in each group.Results: (1) RBP4 level, GS score, FPG and LDL-C in the experimental group were all higher than those in the control group, and the difference was of statistical significance (p &lt; .05). There was no statistically significant difference in age, gender, TC, TG and HDL-C between two groups. (2) RBP4 was positively correlated to FPG and HbA1c. (3) In patients with senior coronary heart disease accompanying diabetes mellitus, HbA1c was positively correlated to GS score, RBP4 and FPG. (4) RBP4 was a risk factor for coronary artery stenosis in patients with senior coronary heart disease accompanying diabetes mellitus.Conclusions: The level of serum RBP4 in patients with senior coronary heart disease accompanying diabetes mellitus is higher than that in patients with coronary heart disease alone, with a deeper degree of coronary artery lesion. The level of serum RBP4 is increased with the degree of lesion deepened in patients with senior coronary heart disease, suggesting that the level of serum RBP4 is expected to be an early predictor of coronary artery lesion for patients with senior coronary heart disease.