Relationship Between Glycosylated Hemoglobin,Apolipoprotein B And Severity Of Coronary Artery Disease In Patients With Acute Myocardial Infarction

Objective:The aim of this study was to investigate the relationship between the levels of Hb A1c and Apo-B and the severity of coronary artery disease assessed by Gensini score in patients with acute myocardial infarction(AMI).Methods:We retrospectively analyzed the clinical data of 112 patients with AMI who received coronary angiography(CAG)at the Fourth Affiliated Hospital of China Medical University from January 1,2019 to December 31,2019,including general information,past history,laboratory indicators,electrocardiogram,echocardiogram,and coronary artery lesions.The Gensini score was calculated,and the patients were divided into high score group(Gensini score>60 points,55 cases)and low score group(Gensini score≤60 points,57 cases)according to the median score.Then,the basic data between the groups were compared.Logistic regression analysis and receiver operating characteristic(ROC)curve were carried out to analyze the factors influencing the severity of coronary artery disease in AMI patients.Spearman correlation analysis was utilized to analyze the relationship between Hb A1c and Apo-B levels and the severity of coronary artery disease in AMI patients.Results:1.The proportion of diabetes mellitus(DM)(P=0.014),and the levels of Hb A1c(P=0.000),Apo-B(P=0.045),WBC(P=0.039),PLT(P=0.013),FBG(P=0.003)and BNP(P=0.047)were higher in patients of high score group.The results were considered statistically significant.2.As revealed by regression analysis,Hb A1c(P=0.001),ZApo-B(P=0.011),DM(P=0.015),FBG(P=0.008),WBC(P=0.049),PLT(P=0.016),BNP(P=0.029)and LVEF(P=0.042)were predictors of the severity of coronary artery disease in AMI patients.Hb A1c(OR value:1.804,95%CI:1.009～3.224,P=0.046)and ZApo-B(OR value:1.896,95%CI:1.026～3.504,P=0.041)were independent predictors.3.Spearman correlation analysis revealed that Hb A1c(r_s=0.288,P=0.002)and Apo-B(r_s=0.214,P=0.024)were positively correlated with the severity of coronary artery disease assessed by Gensini score in AMI patients.The results were considered statistically significant.4.ROC curve indicated that Hb A1c and Apo-B levels had good specificity and sensitivity.Moreover,the combination of Hb A1c and Apo-B had a better predictive value for the severity of coronary artery disease.Conclusion:In conclusion,both Hb A1c and Apo-B can aid in the evaluation of the severity of coronary artery disease,and the combination of the two can improve the predictive efficiency.