Sanna Giuseppe D, Canonico Mario E, Siciliano Roberta, Guarino Simona, Montereggi Francesco, Ponti Enrico, Corda Giulia, Talanas Giuseppe, Parodi Guido
Cardiovascular Department, Sassari University Hospital.
Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
J Cardiovasc Med (Hagerstown). 2021 Nov 1;22(11):813-817. doi: 10.2459/JCM.0000000000001227.
The impact of glucose-6-phosphate dehydrogenase (G6PD) deficiency on coronary atherosclerosis has not been clearly investigated so far. We aimed to assess the effects of G6PD deficiency on the extent and complexity of coronary atherosclerosis in a large unselected cohort of consecutive patients with acute coronary syndromes (ACS).
We studied 623 consecutive patients presenting with ACS and undergoing coronary angiography and percutaneous coronary intervention (PCI). G6PD activity was quantitatively measured in all individuals using a biochemical assay based on the G6PD/6GPD ratio in erythrocytes. Individuals were defined as deficient when the ratio was less than 0.80. The severity and complexity of coronary atherosclerosis were assessed by SYNTAX score at baseline angiography.
Fifty-six patients (9%) showed G6PD deficiency. Severe (i.e. enzymatic activity < 0.10) G6PD deficiency was detected in 33 (5.3%) individuals, mainly of male sex (n = 32). Overall, the cardiovascular risk profile was similar between patients with G6PD deficiency and controls. Patients with G6PD deficiency showed similar severity and complexity of coronary atherosclerosis as compared to control patients; accordingly, the SYNTAX score (15 vs. 14.5, P = 0.90, respectively, in G6PD-deficent patients and controls), and all its components were similar between deficient individuals and controls. The only independent predictor of a SYNTAX score of more than 22 was patients' age (odds ratio 1.035, 95% confidence interval 1.018-1.051; P < 0.001).
G6PD deficiency does not impact on the extent and complexity of coronary atherosclerosis assessed by coronary angiography in patents presenting with ACS.
葡萄糖-6-磷酸脱氢酶（G6PD）缺乏对冠状动脉粥样硬化的影响迄今尚未得到明确研究。我们旨在评估G6PD缺乏对一大组未经选择的连续性急性冠状动脉综合征（ACS）患者冠状动脉粥样硬化程度和复杂性的影响。
我们研究了623例连续性ACS患者，这些患者均接受了冠状动脉造影和经皮冠状动脉介入治疗（PCI）。使用基于红细胞中G6PD/6GPD比值的生化检测方法对所有个体进行G6PD活性的定量测定。当该比值小于0.80时，个体被定义为缺乏。在基线血管造影时通过SYNTAX评分评估冠状动脉粥样硬化的严重程度和复杂性。
56例患者（9%）表现出G6PD缺乏。在33例（5.3%）个体中检测到严重（即酶活性<0.10）G6PD缺乏，主要为男性（n = 32）。总体而言，G6PD缺乏患者与对照组的心血管风险特征相似。与对照患者相比，G6PD缺乏患者的冠状动脉粥样硬化严重程度和复杂性相似；因此，SYNTAX评分（G6PD缺乏患者和对照组分别为15和14.5，P = 0.90）及其所有组成部分在缺乏个体和对照组之间相似。SYNTAX评分超过22的唯一独立预测因素是患者年龄（优势比1.035，95%置信区间1.018 - 1.051；P < 0.001）。
在患有ACS的患者中，G6PD缺乏对通过冠状动脉造影评估的冠状动脉粥样硬化程度和复杂性没有影响。
