A Study Of Correlation Between The Level Of Inflammatory Factors In Acute Myocardial Infarction Patient With Pathoglycemia And Cardiac Events

Background:In recent years, morbidity of acute oronary syndrome (ACS) showed an increasing trend that bring a serious threat to human health, especially in patients with acute myocardial infarction (AMI).In recent years, we have found that inflammation plays a vital role in the development of coronary heart disease(CHD). Relationship of inflammation and inflammatory factors with AMI has increasingly become the focus of attention. Currently considered that unstable plaque rupture and coronary artery obstruction caused by acute thrombosis is the main mechanism of AMI attack.Recent studies have shown that acute coronary syndrome is closely related to plaque instability,rupture, and secondary thrombosis caused by inflammation. Pathoglycemia—one of the major risk factors for cardiovascular disease significantly increased cardiovascular disease morbidity. In recent years, more and more evidence showed that the atherosclerotic plaque in the patients with pathoglycemia are more unstable compared with non-diabetic patients. Pathoglycemia includes diabetes mellitus(DM) and impaired glucose tolerance (IGT). More and more experts increasingly began to identify a point of view that inflammation is a common pathogenesis of coronary heart disease and pathoglycemia. Inflammation may be a common precursor and a bond of connection of diabetes and coronary heart disease development. Series of clinical studies have shown that hs-CRP can be used as the independent factor predicting coronary events. The significance of hs-CRP is to indicate the relationship between inflammation development and prediction of long-term cardiovascular risk events. Although there has been more basic and clinical research of the relationship between hs-CRP and atherosclerosis.In addition, IL-6 is also commonly used to indicate the cardiovascular events.The patients with acute myocardial infarction and diabetes secondary prevention is very important. In this research,we analysis the level of Hs-CRP、IL-6 in the patients with acute myocardial infarction and diabetes who received Percutaneous Coronary Intervention (PCI), and the independent predictive value on relapsed cardiac events for acute myocardial infarction patients with diabetes in the secondary prevention.Objective:1.The purpose of this study was to determine the characteristics and differences of bioc hemical indices in serum in patients with and without pathoglycemia who suffered from an acute myocardial infarction(AMI).The biochemical indices in serum of this study analysed included hig h sensitivity C reactive protein (Hs-CRP) and interleukin-6 (IL-6). 2. Another purpose was to definite the predictive effect of biochemical indices when patients with myocardial infarction and pathoglycemia suffered from second coronary events.Methods:Patients:This study included 185patients in accordance with the relevant inclusion and e xclusion criterias,who suffered from an acute myocardial infarction and underwent the surgery of percutaneous coronary intervention (PCI) in Lanzhou Military Region General Hospital of Lanzho u. We consider that this 55 patients with pathoglycemia is group A, this 130 patients without pathoglycemia is group B,and control group are the 50 patients without obvious stenosis juging through the coronary arteriongraphy.1.Methods:The research methods was to review the patients’ medical history, characteristics and b iochemical indices in serum.The medical history and characteristics of patients included age, gend er, smoking status, alcohol consumption, hypertension, diabetes, hyperlipemia and history of med ication.2.The biochemical indices in serum included blood sugar, Hs-CRP,IL-6,total bilirubin, dir ect bilirubin, indirect bilirubin, serum triglyceride, total cholesterol, low density lipoprotein, high density lipoprotein cholesterol concentration.3.Statistical analysis data were analyzed with spss 19.0.for P<0.05,results were considered as statistically significant. Categorical variables were demonstrated as number(percentage). Measurement features between groups and subgroups were evaluated with independent-samples T test, while Chi-square test was used for the categorical variables. Pearson bivariate correlation was used to analyze the correlation between variables. Binary logistic regression model was used to evaluate the predict power of all the indexes on relapsed cardiac enents in coronary heart disease patients with pathoglycemia.Results:1.Compared with the control group, the level of Hs-CRP in A group and B group all increased. Acute myocardial infarction with pathoglycemia group increased the most,followed by acute myocardial infarction without pathoglycemia group and control group.Difference was statistically significant compared diabetes with acute myocardial infarction group with the other three groups(p<0.05).2.Compared with the control group, the level of IL-6 in A group and B group all increased. Acute myocardial infarction with pathoglycemia group increased the most,followed by acute myocardial infarction without pathoglycemia group and control group.Difference was statistically significant compared diabetes with acute myocardial infarction group with the other three groups(p<0.05).3.Compared with B group, the level of Hs-CRP in pathoglycemia with acute myocardial infarction group increased. Difference was statistically significant (p<0.05).4.Compared with B group, the level of IL-6 in pathoglycemia with acute myocardial infarction group increased. Difference was statistically significant (p<0.05).5.multivariate Logistic regression model to explore the Hs-CRP、IL-6 is the independent risk factors for adverse cardiovascular events.Conclusion:.1.The level of Hs-CRP、IL-6 have independent predictive value on relapsed cardiac events in the acute myocardial infarction with diabetes group and acute myocardial infarction without pathoglycemia(p<0.05).2.The level of Hs-CRP、IL-6 in acute myocardial infarction with pathoglycemia group all increased, which predicted higher risk of cardiac events in the patients with AMI.3.The level of IL-6、Hs-CRP have independent predictive value on relapsed cardiac events in the acute myocardial infarction with pathoglycemia group,which can guide the secondary prevention of acute myocardial infarction with pathoglycemia after PCI.