Vascular endothelial function of patients with stable coronary artery disease

Association between endothelin-1, nitric oxide, and Gensini score in chronic coronary syndrome

BACKGROUND

Chronic coronary syndrome (CCS) is a major public health burden; its pathogenesis involves atherosclerosis and endothelial dysfunction. Endothelin-1 (ET-1) and nitric oxide (NO) are vasoactive substances synthesized by endothelial cells that play a crucial role in CCS development. The Gensini score (GS) is used for evaluating CCS severity based on lumen segment changes, stenosis degree, and coronary stenosis site.

METHODS

This prospective study included 71 patients with CCS; we evaluated the relationships between GS and ET-1 and NO serum levels were evaluated in these patients. The GS was calculated for all patients. Serum ET-1 & NO levels among other laboratory parameters were measured.

RESULTS

The high GS group had higher ET-1 and relatively NO expressions in the than the low GS group. GS was positively correlated with ET-1 and negatively correlated with NO, T4, and TSH levels. The results of the multiple linear regression analysis showed that ET-1 had the most significant effect on GS.

CONCLUSIONS

We found a strong association between ET-1, NO, and CCS severity. A combination of ET-1, NO, and GS is an essential predictor of CCS disease severity.

Predictive nomogram for coronary heart disease in patients with type 2 diabetes mellitus

OBJECTIVE

This study aimed to identify risk factors for coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM), build a clinical prediction model, and draw a nomogram.

STUDY DESIGN AND METHODS

Coronary angiography was performed for 1,808 diabetic patients who were recruited at the department of cardiology in The Second Affiliated Hospital of Nanchang University from June 2020 to June 2022. After applying exclusion criteria, 560 patients were finally enrolled in this study and randomly divided into training cohorts (n = 392) and validation cohorts (n = 168). The least absolute shrinkage and selection operator (LASSO) is used to filter features in the training dataset. Finally, we use logical regression to establish a prediction model for the selected features and draw a nomogram.

RESULTS

The discrimination, calibration, and clinical usefulness of the prediction model were evaluated using the c-index, receiver operating characteristic (ROC) curve, calibration chart, and decision curve. The effects of gender, diabetes duration, non-high-density lipoprotein cholesterol, apolipoprotein A1, lipoprotein (a), homocysteine, atherogenic index of plasma (AIP), nerve conduction velocity, and carotid plaque merit further study. The C-index was 0.803 (0.759-0.847) in the training cohort and 0.775 (0.705-0.845) in the validation cohort. In the ROC curve, the Area Under Curve (AUC) of the training set is 0.802, and the AUC of the validation set is 0.753. The calibration curve showed no overfitting of the model. The decision curve analysis (DCA) demonstrated that the nomogram is effective in clinical practice.

CONCLUSION

Based on clinical information, we established a prediction model for CHD in patients with T2DM.

Positive Expression of Human Cytomegalovirus Phosphoprotein 65 in Atherosclerosis

Previous studies showed that human cytomegalovirus (HCMV) is associated with atherosclerosis. However, local vascular atherosclerosis related HCMV infection and protein expression remain unclear. This study aimed to assess the relationship between HCMV infection and atherosclerosis. Formalin-fixed, paraffin-embedded peripheral artery specimens were obtained from 15 patients with atherosclerosis undergoing vascular surgery from 2008 to 2010 at Zhongnan Hospital, Wuhan University. Pathological analyses were carried out after hematoxylin and eosin (H&E) and Masson trichrome staining. In situ hybridization and immunohistochemistry with two different monoclonal antibodies were employed to detect HCMV nucleic acids and proteins, respectively. H&E and Masson trichrome staining showed homogeneous extracellular matrix in femoral artery, while smooth muscle fibers were interlaced with collagen fibers; in carotid artery, inflammatory cell infiltration, foam cell vascular change, cholesterol crystals, and layered collagen fibers were observed. In situ hybridization showed no expression of HCMV nucleic acids in all 15 cases. Immunohistochemical staining for protein immediate-early protein (IE1 72) was negative in all cases, while phosphoprotein 65 (pp65) expression was detected in 14 cases. A high rate of positive pp65 signals was found in patients with atherosclerosis, suggesting that local HCMV infection may be associated with the pathogenesis of atherosclerosis. Further studies on this relationship are warranted.