Heat Shock Protein 60, 65 Acute Coronary Syndrome Patients With Diabetes Short-term Prognosis Impact

Objective To analysis the effect of heat shock protein 60 (HSP60) and heat shock protein 65 (HSP65) on reaction of the severity of diabetic patients with coronary heart disease (CHD) at the time of admission, and to investigate the relationship between HSP60, HSP65 and other risk factors with CHD. And focus on discussion the role of short-term prognosis about human HSP60, HSP65 in diabetic patients with acute coronary syndrome (ACS).Methods 89 cases of hospitalized patients with diabetes were collected from department of cardiovascular disease, Wuxi People's Hospital affiliated to Nanjing Medical University from November 2009 to May 2010, which were divided into ACS group, stable angina pectoris (SAP) group and non-CHD group. All patients underwent coronary angiography. Patient's information was collected in questionnaire, which contained all the clinical data of patients, biochemical tests, left ventricular ejection fraction and brain natriuretic peptide. Immediately HSP60, HSP65 levels in human serum were measured in all patients with enzyme-linked immunosorbent assay at the time of admission. And established follow-up records of all patients to observe the recent occurrence of cardiovascular events, discussed the relationship between HSP60, HSP65 and coronary events in 6 months.Results 1. HSP60 and HSP65 in ACS group were all significantly higher than SAP group and non-CHD group (P<0.05). HSP60 had no significantly difference between SAP group and non-CHD group, but HSP65 had higher level in SAP group than non-CHD group (P<0.05). 2. Correlations between HSP60, HSP65 and other index which could react the severity of CHD showed, there were positive correlation between HSP60,HSP65 and brain natriuretic peptide (BNP), creatine kinase MB, aspartate aminotransferase, lactate dehydrogenase, Gensini points(P <0.05), and negative correlation with left ventricular ejection fraction(LVEF)(P <0.05). And we found there had positive correlation between HSP60 and HSP65 (r=0.691, P<0.001).3. Conventional risk factors of CHD such as age, sex, blood pressure, alcohol consumption, body mass index and blood lipid levels had no effect on HSP60 and HSP65 levels in serum. However, we found smoking can affect the levels of HSP60 without HSP65, HSP60 was significantly higher in the patients with current smoking than never smokers (P <0.05). 4. Follow-up results: 86 cases were of successful follow-up, lost in 3 cases. 17 cases of patients had cardiovascular events within six months, the serum content of HSP60 and HSP65 were significantly higher in patients with cardiovascular events than without cardiovascular events (P <0.05). COX regression analysis showed that HSP65 was an independent risk factor for cardiovascular events in 6 months in patients with diabetes and ACS (P = 0.036). Conclusions Detection of HSP60 and HSP65 in patients with diabetes and CHD had important value, they can be used as biochemical indexes in reaction the severity and prognosis of disease. HSP65 was an independent risk predictor of diabetic patients with ACS in recent cardiovascular events.