| Background and objective:Acute coronary syndromes(ACS)include acute ST segment elevation myocardial infarction(STEMI),non-ST segment elevation myocardial infarction(NSTEMI)and unstable angina pectoris(UA)is a disease with high incidence rate and mortality rate of coronary heart disease.Its onset is rapid and is seriously threatening people’s health and life.Therefore,it is very important to judge the severity of coronary artery disease in ACS patients as soon as possible and intervene in time for the improvement of prognosis.In recent years,many studies from domestic and foreign have shown that there is a correlation between Aldehyde dehydrogenase 2(Aldhyde Dehydrogenase 2,ALDH2)and coronary heart disease,and ALDH2 gene may participate in the development process of atherosclerosis through a variety of mechanisms.Drinking as a lifestyle that can be regulated,its research has been conducted for many years,but there is no conventional alarmation in the domestic and foreign relationships.The purpose of this study is to explore whether ALDH2 Gene Polymorphism and alcohol intake can be used as specific risk factors for the severity of coronary artery disease in patients with acute coronary syndrome,so as to achieve the purpose of early prevention and intervention.Methods:Retrospective analysis of patients with ACS who were diagnosed by coronary angiography and ALDH2 Gene examination in the Department of Cardiology of Baotou Central Hospital from September 2019 to December 2020.The general data of the subjects were collected by standardized questionnaire survey and laboratory examination,and each subject underwent coronary angiography.According to the results of coronary angiography,Gensini was calculated Gensini score was divided into three subgroups:mild coronary artery disease group(Gensini score<20),moderate coronary artery disease group(Gensini score 20-60),and severe coronary artery disease group(Gensini score<20)According to ALDH2 Gene detection results,patients were divided into wild type(GG),heterozygous mutation(GA)and homozygous mutation(AA)of ALDH2 Gene;patients with ACS were divided into acute ST segment elevation myocardial infarction group,non acute ST segment elevation myocardial infarction group and unstable angina pectoris group;the total alcohol intake of each subject per week was converted into standard unit(1 unit=8g ethanol),and all the patients were enrolled The subjects were divided into three groups according to alcohol intake:non drinking group(<1 unit/week),low to moderate drinking group(1-21 units/week for male and 1-14 units/week for female),and heavy drinking group(21 units/week for male and 14 units/week for female).General clinical data and genotyping data were collected.Logistic regression analysis was used to analyze the relationship between ALDH2 Gene and coronary Gensini score,and the relationship between alcohol intake and coronary Gensini score.Results:(1)a total of 325 people were selected in this study.Hardy Weinberg equilibrium test of ALDH2 gene locus was performed by using haploview software.The distribution of ALDH2 genotypes GG,GA and AA(χ~2=2.841,P=0.092)in the study subjects conformed to hardy Weinberg equilibrium law,reached the genetic equilibrium,and was representative of the population.(2)There was no significant difference in age,BMI,triglyceride,high density lipoprotein,NT-pro BNP,hypertension and diabetes among the three groups(P>0.05).Compared with the other two groups,STEMI group had higher proportion of male and smoking,lower level of low-density lipoprotein,higher levels of total cholesterol and creatinine(P<0.05).(3)the proportion of genotype AA and GA in UA group was lower than that in acute ST segment elevation myocardial infarction group and non-ST segment elevation myocardial infarction group,while the proportion of genotype GG was higher(P<0.05).(4)Relationship between ALDH2 Gene Polymorphism and severity of coronary artery disease:logistic regression analysis showed that ALDH2 Gene mutation(GA/AA)(OR:82.16,95%CI:25.42-265.53)was an independent risk factor for severity of coronary artery disease.(5)Relationship between alcohol intake and severity of coronary artery disease:statistical results showed that heavy drinking was an independent risk factor for severity of coronary artery disease(OR:2.05,95%CI:1.29-3.24).After adjusting for age,gender,smoking,hypertension,diabetes,BMI,HDL,LDL,TC,TG,ALT and AST,the above relationships still exist.There is an interaction between ALDH2 Gene mutation and drinking,and the presence of both can further aggravate the severity of coronary artery disease.Conclusion:(1)ALDH2 Gene mutation is an independent risk factor for the severity of coronary artery disease in ACS patients,which may become a reliable index for evaluating the severity of coronary artery disease in ACS patients;(2)the alcohol intake of ALDH2 Gene Mutation patients is significantly less than that of ALDH2 Gene normal people;(3)Heavy drinking is an independent risk factor for the severity of coronary artery disease in patients with ACS;(4)the incidence of coronary artery disease in ACS patients with ALDH2 Gene mutation is significantly lower than that of ALDH2 Gene normal people ALDH2 Gene mutation and drinking can further aggravate the severity of coronary artery disease in ACS patients. |
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