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Title: The Correlation Between Apolipoprotein A and Coronary Artery Stenosis in Type 2 Diabetes Patients with Acute Coronary Syndrome
Abstract:
Objective: This study aims to investigate the correlation between apolipoprotein A (apo A) levels and the degree of coronary artery stenosis in patients with acute coronary syndrome (ACS) and type 2 diabetes mellitus (T2DM).
Methods: A total of XX patients diagnosed with ACS and T2DM were enrolled in this cross-sectional study. The plasma apo A levels were measured by enzyme-linked immunosorbent assay (ELISA). Coronary angiography was performed to evaluate the degree of coronary artery stenosis using the Gensini score.
Results: The plasma apo A levels were found to be significantly lower in T2DM patients with ACS compared to those without ACS (p<). Moreover, there was a negative correlation between apo A levels and the Gensini score (r=-, p<), indicating that lower apo A levels were associated with a higher degree of coronary artery stenosis.
Conclusion: Our findings suggest that lower apo A levels are associated with more severe coronary artery stenosis in T2DM patients with ACS. Further studies are necessary to explore the underlying mechanisms and evaluate the potential of apo A as a biomarker for cardiovascular risk stratification in this patient population.
Introduction:
Type 2 diabetes mellitus (T2DM) is a significant risk factor for the development of cardiovascular diseases, including acute coronary syndrome (ACS). Patients with ACS and T2DM often exhibit more severe coronary artery stenosis and have worse clinical outcomes compared to those without diabetes. Therefore, it is crucial to identify specific biomarkers that can help risk stratification and guide treatment decisions in this patient population.
Apolipoprotein A (apo A), the main protein component of high-density lipoprotein (HDL), plays a crucial role in reverse cholesterol transport and has been linked to cardiovascular health. Lower levels of apo A have been found in patients with T2DM and have been associated with an increased risk of cardiovascular events. However, the relationship between apo A levels and the degree of coronary artery stenosis in T2DM patients with ACS remains unclear. Therefore, this study aims to investigate the correlation between apo A levels and the severity of coronary artery stenosis in this specific patient population.
Methods:
Study Design and Participants:
This cross-sectional study included XX patients diagnosed with ACS and T2DM. Patients were recruited from XX hospital between XXX and XXX. Inclusion criteria included age over 18 years, confirmed diagnosis of T2DM according to the World Health Organization criteria, and the presence of ACS confirmed by clinical symptoms, electrocardiography, and elevated cardiac biomarkers (., troponin). Patients with a history of myocardial infarction, coronary artery bypass grafting, or percutaneous coronary intervention were excluded from the study.
Data Collection:
Demographic and clinical data including age, gender, body mass index, smoking status, and duration of diabetes were recorded for all patients. Fasting blood samples were collected to measure plasma apo A levels using ELISA according to the manufacturer's instructions. Coronary angiography was performed to assess the severity of coronary artery stenosis using the Gensini score, which takes into account the number, location, and degree of stenosis in the major coronary arteries.
Statistical Analysis:
Statistical analysis was performed using SPSS version XX (SPSS Inc., Chicago, IL, USA). Data were expressed as mean ± standard deviation for normally distributed variables and median (interquartile range) for non-normally distributed variables. The Student's t-test or Mann-Whitney U test was used for between-group comparisons, depending on the normality of the data. Correlations between variables were assessed using Pearson's or Spearman's correlation analysis, as appropriate. A p-value < was considered statistically significant.
Results:
The demographic and clinical characteristics of the study population are summarized in Table 1. The mean age of the patients was XX years, with XX% being male. The mean duration of diabetes was XX years. The distribution of coronary artery stenosis severity according to the Gensini score is presented in Table 2.
The plasma apo A levels were found to be significantly lower in T2DM patients with ACS compared to those without ACS (p<) (Figure 1). Additionally, a negative correlation was observed between apo A levels and the Gensini score (r=-, p<) (Figure 2), indicating that lower apo A levels were associated with a higher degree of coronary artery stenosis.
Discussion:
ACS is a major cause of morbidity and mortality in patients with T2DM, and identifying novel biomarkers associated with disease severity is of great clinical importance. Our study demonstrates that lower plasma apo A levels are associated with more severe coronary artery stenosis in T2DM patients with ACS. These findings are consistent with previous studies showing that low apo A levels are associated with an increased risk of cardiovascular events in patients with T2DM.
Apo A is involved in several protective mechanisms, including reverse cholesterol transport, anti-inflammatory effects, and antioxidant properties. The reduction in apo A levels in T2DM patients may result from the dysregulation of HDL metabolism, impaired cholesterol efflux, or increased oxidative stress. The link between low apo A levels and severe coronary artery stenosis may be attributed to the impaired reverse cholesterol transport, which leads to increased plaque formation and inflammation in the coronary arteries.
Conclusion:
In conclusion, our study demonstrates a significant correlation between lower apo A levels and more severe coronary artery stenosis in T2DM patients with ACS. These findings highlight the potential of apo A as a biomarker for cardiovascular risk stratification and treatment decision-making in this specific patient population. Further research is needed to elucidate the underlying mechanisms and explore the potential therapeutic implications of apo A in improving clinical outcomes in T2DM patients with ACS.