| Objectives To investigate the effect of metformin on the level of LP(a)and MACE in patients with acute myocardial infarction and type 2 diabetes mellitus after emergency percutaneous coronary intervention.Methods From 2018 to 2020,patients with type 2 diabetes mellitus who received emergency intervention were admitted to the Affiliated Hospital of North China University of technology and Feng Run People’s Hospital for acute myocardial infarction.A total of118 patients with complete basic data,regular medication and timely follow-up were included by filling in the questionnaire,telephone follow-up,consulting the outpatient electronic case appointment and follow-up system and inpatient electronic case system.Patients were divided into metformin group(51 cases)and control group(67 cases)according to whether they received regular metformin treatment during one year after discharge.The general data collected include age,gender,body mass index,type 2 diabetes history,hypertension,stroke,drinking history and smoking history.Collecting clinical examination and examination data,including: blood routine: leukocyte,platelet and platelet distribution width;Blood biochemical indexes: total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,LP(a),apolipoprotein A,apolipoprotein B;Blood uric acid,calcium and phosphorus;Coagulation indexes: activated partial coagulation time and prothrombin time;Coronary angiography data: location and number of coronary artery lesions;Mace events(reinfarction,heart failure,angina pectoris attack,stroke,cardiac death)and LP(a)level at 1 year were recorded within 12 months after discharge.The differences of the above indexes between metformin group and control group,metformin group before and after treatment and control group before and after treatment were analyzed and compared.Results 1.Metformin group compared with the control group,there was no significant difference in age,body mass index,gender,drinking history,smoking history,type 2diabetes prevalence,history of hypertension,history of stroke,medication history,TC,TG,HDL-C,LDL-C,LP(a),Apo A,Apo B,fasting blood glucose,PT,APTT,uric acid,Ca,P,coronary artery disease vessel count,and vascular location.2.Compared with one year ago,the levels of TC,TG,LDL-C and Apo B in metformin group decreased significantly compared with one year ago,the difference was statistically significant,P < 0.05;There was no significant difference in the levels of LP(a),HDL-C and Apo A,P > 0.05.The levels of TC,TG,LDL-C and Apo B in the control group were significantly lower than those one year ago,P < 0.05;There was no significant difference in the levels of LP(a),HDL-C and Apo A,P > 0.05.3.Compared with the control group,mace event 25(49.02)in metformin group was significantly lower than that in control group 45(67.16),reinfarction 6(11.76),and significantly lower than that in control group 18(26.87),the difference was statistically significant,P < 0.05.4.Multivariate binary logistic regression analysis was carried out with age,gender,hypertension,regular use of metformin,smoking history,drinking history,admission fasting blood glucose,body mass index,admission LP(a),LDL-C,TG,TC,Apo A and Apo B as dependent variables and independent variables.The results showed that body mass index(OR = 1.501,P < 0.001)and LP(a)(OR = 1.002,P = 0.037)are independent risk factor for mace event.Oral metformin(OR = 0.229,P = 0.006)was a protective factor for MACE events within 1 year of myocardial infarction.Conclusions 1.Metformin is a protective factor for MACE events in 1 years after discharge from patients with acute myocardial infarction and type 2 diabetes.2.Body mass index(BMI)and LP(a)were independent risk factors for MACE events in patients with acute myocardial infarction and type 2 diabetes who had been discharged from hospital for1 years.3.Metformin had no effect on LP(a)level for 1 year.Figure 0;Table 14;Reference 134... |
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