Significance of plasma lipoprotein a,apolipoprotein A-Ⅰ/apolipoprotein B ratio in type 2 diabetes patients with acute coronary syndrome
Objective To analyze the changes and clinical characteristics of plasma lipoprotein(a)[Lp(a)]and apolipoprotein A-Ⅰ/apolipoprotein B(ApoA-Ⅰ/ApoB)ratios in patients with acute coronary syndrome(ACS)and type 2 diabetes.Methods Two hundred and thirteen patients with ACS who were treated from January 2022 to March 2023 were selected in this study.The observation group(n=74)was ACS patients with type 2 diabetes,and the control group(n=139)was simple ACS patients.Lp(a)and ApoA-Ⅰ/ApoB ratio of the two groups were analyzed.Results The body mass index and the proportion of individuals with a history of hypertension in the observation group were higher than those in the control group(P＜0.05).The Lp(a)level in the multi-vessel lesion group was higher than that in the single vessel lesion group and the dual vessel lesion group(P＜0.05),and the ApoA-Ⅰ/ApoB ratio in the multi-vessel lesion group was lower than that in the single vessel lesion group and the multi-vessel lesion group with statistical significance(P＜0.05).The Lp(a)level in the control group with multiple vessel lesions was higher than that in the single vessel lesion group and the dual vessel lesion group,and the ApoA-Ⅰ/ApoB ratio was lower than that in the single vessel lesion group and the multi-vessel lesion group(P＜0.05).In the observation group Gensini integral subgroup,the Lp(a)level in the high group was higher than that in the low group,and the ApoA-Ⅰ/ApoB ratio was lower than that in the low group(P＜0.05).There was no statistically significant difference in Lp(a)levels and ApoA-Ⅰ/ApoB ratio between the low and high groups in the Gensini score subgroup of the control group(P＞0.05).The observation group's GRACE score subgroup showed that the ApoA-Ⅰ/ApoB ratio in the high-risk group was lower than that in the low-risk and medium-risk groups,and the Lp(a)value was higher than that in the low-risk and medium-risk groups(P＜0.05).There was no statistically significant difference in the ApoA-Ⅰ/ApoB ratio and Lp(a)value between the observation group and the control group(P＞0.05).Logistic regression analysis showed that the increase of Lp(a)level was a risk factor for multi-vessel coronary artery disease in ACS patients with type 2 diabetes,and the increase of ApoA-Ⅰ/ApoB ratio was a protective factor for multi-vessel coronary artery disease and the degree of coronary stenosis in ACS patients with type 2 diabetes(P＜0.05).Conclusion Detection of Lp(a)level and ApoA-Ⅰ/ApoB ratio can guide clinical prediction of multi-vessel disease and serious coronary artery disease in ACS patients with type 2 diabetes.
Diabetes mellitus,type 2Acute coronary syndromePlasma,lipoprotein aApolipoprotein A-Ⅰ/Apolipoprotein B
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