Coronary Heart Disease(CHD) Combined With Type 2 Diabetes Glycated Hemoglobin Level And The Correlation Analysis Of Cardiac Function

Background and ObjectiveAlong with our country socialist economy sustainable and rapid development,urban residents steadily improve the level of material life security,old age disease of heart head blood-vessel especially system disease of heart head blood-vessel increasing morbidity and mortality and increases,for human health dangers may cause by the rising,a serious threat to the national work and the quality of life.Including coronary heart disease(Coronaryheartdisease,CHD)and due to the increasing number of cases and deaths of rise,most of the patients at the same time,long associated with Type 2 diabetes(Type 2 diabetes T2DM).Clinical studies have shown that type 2 diabetes is aggravating coronary vascular lesions progress,lead to the important risk factor for coronary heart disease death rates,persistent abnormal glucose metabolism level will directly lead to coronary heart disease(CHD)in patients with coronary artery lesion degree aggravating and induce acute myocardial infarction,heart failure,the risk of sudden cardiac death and other disease further.Scientific assessment of the coronary heart disease combined with type 2 diabetes sugar metabolism and the correlation of cardiac function,is advantageous to the reasonable control of blood glucose levels in patients with,to effectively improve prevention and treatment of patients with coronary artery vascular lesions further and cause heart failure,sudden cardiac death has certain help.Glycosylated hemoglobin(Glycosylated hemoglobin,HbAlc)as a reflection of diabetes sugar metabolism important measure,is generally thought that it can be used to reflect the nearly 8～12 weeks in patients with blood sugar levels under control,can more effectively evaluate over a period of sugar metabolism.At home and abroad of glycosylated hemoglobin levels and coronary vascular lesions of the study is more,the correlation studies of glycosylated hemoglobin levels and heart function is lack,this study through the analysis of system of coronary heart disease combined with type 2 diabetes glycated hemoglobin level and the correlation of cardiac function,to provide reasonable blood glucose management for these patients and new ideas of cardiovascular adverse events.Materials and methods1 Research object:in October 2017-in October 2018,our hospital 150 cases of coronary heart disease combined with type 2 diabetes,inclusion criteria:(1)in accordance with the international association of cardiology and the world health organization in the nomenclature and criteria for diagnosis of ischemic heart disease on coronary atherosclerosis nomenclature and diagnostic criteria of ischemic heart disease;By Coronary angiography(Coronary arteriography,the CAG)diagnosed with Coronary atherosclerotic heart disease;(2)in accordance with the world health organization(WHO)on type 2 diabetes diagnosis standards;(3)always rule continued drug use more than one year;(4)exclusion criteria:(1)always suffered from Chronic totally occluded coronary artery lesions(Chronic total occlusions,CTO),myocardial infarction,Arrhythmia(Myocardialinfarction,MI)(Arrhythmia)history and related complications;(2)the existence of Chronic heart failure(Chronic heart failure,CHF),Chronic obstructive pulmonary disease(Chronic obstructive pulmonary diseases,COPD);(3)always had walked skin coronary interention(Percutaneous coronary intervention,PCI)and coronary artery bypass grafting(coronary artery bypass grafting,CABG);(4)there are I diabetes,severe liver and kidney diseases,infections,autoimmune diseases and tumors.This study has passed the second affiliated hospital of zhengzhou university ethics committee approval.2 Group by:according to the determination of the hospitalized patients with HbAlc level will be divided into three groups:group A HbAlc<6.5%(n=45)and group B HbA1c 6.5～8.5%(n=62),group C HbAlc>8.5%(n=43).3 Methods:selected patients’ general information collection mainly includes:gender,age,history of hypertension,coronary heart disease family history,etc.,measure the height,weight,Body Mass Index(BMI)and calculate the(Body Mass Index,BMI).All patients admitted to hospital after Fasting 12 h rick Fasting venous blood was drawn,detection:blood routine,blood lipid,Fasting glucose,Fasting blood glucose,FPG),glycosylated hemoglobin(HbA1C),hepatic function,renal function,amino terminal,brain natriuretic peptide precursor(N terminal pro brain natriuretic peptide,NT-proBNP)such as index,according to the patients admitted to hospital tests of glycosylated hemoglobin levels will be divided into three groups A,B,C,three groups of patients were performed color doppler echocardiography,measure the Left ventricular ejection fraction(Left ventricular ejection fraction,LVEF),Left ventricular end-diastolic diameter,Left ventricular end diastolic dimension,LVEDD).All three cardiac cycle averaged measurement.According to the three groups of patients with clinical manifestations and symptoms of Heart function classification(see New York Heart Association(New York Heart Association,NYHA)Cardiac function classification standard).Three groups of patients in hospital outpatient follow-up survey a year later the happening of cardiovascular adverse events,including acute myocardial infarction,severe malignant arrhythmia,heart failure,cardiac death,etc.The prognosis of adverse events.4 Statistical analysis:statistical analysis by SPSS 20.0 software,measurement data(x+s)said,using the single factor analysis of variance,count data expressed as a percentage(%),using chi-square test to compare;Level data comparison using rank and inspection;Correlation analysis using Pearson correlation analysis;With P<0.05 for the difference was statistically significant.Result(1)Three groups of patients in the history of sex ratio,age,BMI,blood pressure,smoking history,there was no statistically significant difference between the family history of hyperlipidemia,coronary heart disease(P>0.05).(2)Compare three groups of patients with cardiac function index,left ventricular end-diastolic diameter(LVEDD),NYHA classification,left ventricular ejection fraction(LVEF)and amino terminal difference between brain natriuretic peptide precursor NT-proBNP significant statistical significance(P<0.01),three groups of patients with LVEF and LVEDD,NT-proBNP,NYHA classification two contrast,three groups of LVEF shows the tendency of decrease,LVEF A and B group were significantly higher than that of group C,three groups of NT-proBNP present obvious rising trend,NT-proBNP C group was obviously higher than that in group A and group B.Three groups of LVEDD and NYHA classification have obvious difference.(3)In the prognosis of patients with follow-up three group were found to have poor prognosis,mainly including acute myocardial infarction,heart failure,sudden cardiac death,such as the incidence of adverse events of group A was 2.2%,the incidence of group B was 5.0%,the incidence of group C was 11.6%,the incidence of adverse events C group was obviously higher than that of group A and group B.Compared three groups of incidence of adverse events,there are significant difference statistically significant(P<0.01)(4)Three groups of patients with glycosylated hemoglobin(HbA1C)level and LVEF and LVEDD,NT-proBNP,NYHA classification has significant correlation(P<0.01),and negatively correlated with LVEF,and LVEDD,NT-proBNP,NYHA classification were positively correlated.ConclusionThis study showed that patients with coronary heart disease(CHD)with type 2 diabetes glycated hemoglobin level has certain correlation with cardiac function,high glycosylated hemoglobin levels to the cardiac function and prognosis of patients with have certain negative effects,therefore,coronary heart disease(CHD)combined with type 2 diabetes should be timely and effective reasonable control blood sugar levels.