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Changes and Clinic Significance of Inflammatory Factors after Coronary Stenting in Patients of Coronary Artery Disease with Diabetes Mellitus

Author: FengKeFu
Tutor: YanJi
School: Anhui Medical University,
Course: Internal Medicine
Keywords: Coronary artery disease Diabets mellits Inflammatory factors
CLC: R587.1
Type: Master's thesis
Year: 2008
Downloads: 125
Quote: 1
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Abstract


Objective: Patients of coronary artery disease with diabetes mellitus are at increased risk for MACE (major adverse cardiac event) after coronary stenting,the inflammatory reaction active is a critical mechanism.This study aimed to observe the serum levels of special inflammatory cytokines such as hsCRP, sCD40L, ICAM-1 and MMP-9 in coronary artery disease patients with diabetes mellitus and explore their relationships with MACE and clinic significance.Method: 87 consecutive patients with stable angina pectoris who were admitted hospital for PCI and had been successfully received rapamycin eluting coronary stent were enrolled and divided into DM group (n=31) and non-DM group (n=56). Exclusion criteria were with other heart diseases such as dilated cardiomyopathy, hypertrophic obstructive cardiomyopathy and rheumatic heart disease etc,prior PTCA or coronary stenting, hepatic function or renal function dysfunction, unstable angina pectoris or AMI within one month , intolerance of anti-platelet therapy because of hemorrhagic disease and with infection, malignant tumor, hematological system or immunologic system diseases .Perpheral blood sample were taken before, at 24 hours and 1 month after percutaneous coronary interventions(PCI). The level of high sensitive C-reactive protein (hsCRP)、soluble fragment of CD40 ligand(sCD40L)、intercellular adhesion molecule-1(ICAM-1) and matrix metalloproteinase(MMP-9) were detected by enzyme linked immunosement assay(ELASA) and analyzed among the two groups . Logistic regression was used to distinguish the relation between inflammatory factors and MACE.Result: The concentration of hsCRP were significantly higher at 24 hours after PCI,and there were significant difference compared with before or 1 month after PCI in the both groups (p<0.001);but there was no significant difference between the two groups (p>0.05). The concentration of sCD40L and ICAM-1 had elevated tendency after stenting,but there were no significant difference in different times in the two groups (p>0.05).MMP-9 continued elevating and reached the peak at 1 month after PCI in both groups, and there were significant difference compared with before or 24h after PCI (p<0.01),meanwhile there was significant difference between the two groups at 1month after PCI(P<0.01). The incidence of MACE was significant high in DM group after 6 months follow-up(P<0.05), Logistic regression analysis indicated that MMP-9 was one of the main factors of MACE.Conclusion: The expression of inflammation cytokines were various after coronary stenting , MMP-9 had a long-term high expression and related with the MACE,it may be relevant with the increasing of MACE in patients of coronary artery disease with diabetes mellitus after PCI.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Islet disease > Diabetes
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