接受直接经皮冠状动脉介入治疗的首次心肌梗死急性期非糖尿病、糖尿病前期和糖尿病患者的氧化型低密度脂蛋白和高敏C反应蛋白
Oxidized Low Density Lipoprotein and High Sensitive C-Reactive Protein in Non-Diabetic, Pre-Diabetic and Diabetic Patients in the Acute Phase of the First Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention.
作者信息
Trifunović Danijela, Stanković Sanja, Marinković Jelena, Banović Marko, Đukanović Nina, Vasović Olga, Vujisić-Tešić Bosiljka, Petrović Milan, Stepanović Jelena, Đorđević-Dikić Ana, Beleslin Branko, Nedeljković Ivana, Tešić Milorad, Ostojić Miodrag
机构信息
Department of Cardiology, Clinical Centre of Serbia; School of Medicine, University of Belgrade, Serbia.
Center for Medical Biochemistry, Clinical Centre of Serbia, School of Pharmacy, University of Belgrade, Serbia.
出版信息
J Med Biochem. 2015 Apr;34(2):160-169. doi: 10.2478/jomb-2014-0037. Epub 2015 Mar 3.
BACKGROUND
Oxidized low density lipoprotein (ox-LDL) and high-sensitive C-reactive protein (hs-CRP) are elevated in diabetes mellitus (DM) and associated with accelerated atherosclerosis. Little is known about their dynamics in the acute phase of ST segment elevation myocardial infarction (STEMI), especially in relation to the presence of DM and pre-diabetes (pre-DM). This study aimed to analyze time-dependent changes in ox-LDL and hs-CRP regarding the presence of pre-DM and DM in STEMI patients treated by primary percutaneous coronary intervention (pPCI).
METHODS
In 103 consecutive patients with the first anterior STEMI ox-LDL and hs-CRP were measured before pPCI, on day 2 and day 7 after pPCI.
RESULTS
Patients were classified into: non-diabetics, pre-diabetics and diabetics. In each group the maximal ox-LDL concentration was found on admission, decreased on day 2 and reached the lowest values on day 7 (p<0.001). Diabetics had the highest ox-LDL concentrations compared to pre-diabetics and non-diabetics (on admission: p=0.028, on day 2: p=0.056, on day 7: p=0.004). hs-CRP concentration rose from admission, reached its peak on day 2 and decreased on day 7, in each group (p<0.001). Significant differences in hs-CRP concentrations were found between non-diabetics and pre-diabetics on admission (p=0.018) and day 2 (p=0.026). In a multivariate analysis DM was an independent determinant of high ox-LDL concentrations. Both ox-LDL and hs-CRP significantly correlated with Killip class, left ventricular ejection fraction, NT-proBNP and peak troponin I.
CONCLUSIONS
In patients with the first STEMI treated by pPCI there were significant differences in ox-LDL and hs-CRP concentrations between non-diabetics, pre-diabetics and diabetics. Ox-LDL and hs-CRP concentrations were related to heart failure parameters.
背景
氧化低密度脂蛋白（ox-LDL）和高敏C反应蛋白（hs-CRP）在糖尿病（DM）患者中升高，并与动脉粥样硬化加速相关。关于它们在ST段抬高型心肌梗死（STEMI）急性期的动态变化，尤其是与DM和糖尿病前期（pre-DM）的关系，人们了解甚少。本研究旨在分析接受直接经皮冠状动脉介入治疗（pPCI）的STEMI患者中，ox-LDL和hs-CRP随时间的变化情况，以及pre-DM和DM的存在情况。
方法
对103例连续发生首次前壁STEMI的患者，在pPCI前、pPCI后第2天和第7天测量ox-LDL和hs-CRP。
结果
患者分为非糖尿病患者、糖尿病前期患者和糖尿病患者。每组中，ox-LDL的最大浓度在入院时出现，第2天下降，第7天达到最低值（p<0.001）。与糖尿病前期患者和非糖尿病患者相比，糖尿病患者的ox-LDL浓度最高（入院时：p=0.028，第2天：p=0.056，第7天：p=0.004）。每组中，hs-CRP浓度从入院时开始上升，在第2天达到峰值，第7天下降（p<0.001）。在入院时（p=0.018）和第2天（p=0.026），非糖尿病患者和糖尿病前期患者的hs-CRP浓度存在显著差异。在多变量分析中，DM是高ox-LDL浓度的独立决定因素。ox-LDL和hs-CRP均与Killip分级、左心室射血分数、NT-proBNP和肌钙蛋白I峰值显著相关。
结论
在接受pPCI治疗的首次STEMI患者中，非糖尿病患者、糖尿病前期患者和糖尿病患者的ox-LDL和hs-CRP浓度存在显著差异。ox-LDL和hs-CRP浓度与心力衰竭参数相关。
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