Objective To investigate the effects of serum adipokines, inflammatory factors and intestinal flora on major adverse cardiovascular events (MACE) in patients with coronary heart disease after percutaneous coronary intervention (PCI).
Methods A total of 120 coronary heart disease patients with PCI were selected as study group, and 60 healthy individuals with routine health examination in the same period were selected as control group. The differences in serum adipokines adipocyte fatty acid binding protein (AFABP), visceral fat tissue-derived serine protease inhibitor (Vaspin), Apelin, inflammatory factorsinterleukin-6 (IL-6), high mobility group box 1 (HMGB1), high-sensitivity C reactive protein (hs-CRP) and intestinal flora were compared between the two groups. The differences in serum adipokines, inflammatory factors and intestinal flora among patients with different types of coronary heart diseasestable angina pectoris (SAP) in 41 cases, unstable angina pectoris (UAP) in 37 cases, and acute myocardial infarction (AMI) in 42 cases were analyzed. The correlations of inflammatory factors with serum adipokines and intestinal flora were analyzed. The occurrence of MACE was recorded during a year of follow-up in the study group, and the influencing factors of MACE were analyzed.
Results The levels of AFABP, IL-6, HMGB1 and hs-CRP in the study group were significantly higher than those in the control group, while the levels of Vaspin, Apelin, Lactobacillus, Bifidobacterium and Escherichia coli were significantly lower than those in the control group (P < 0.05). The levels of Vaspin in the UAP group and AMI group were significantly lower than that in the SAP group, while the levels of IL-6, HMGB1 and hs-CRP in the AMI group were significantly higher than those in the UAP group and SAP group (P < 0.05). Pearson correlation analysis showed that IL-6, HMGB1 and hs-CRP were positively correlated with AFABP (P < 0.05), while IL-6, HMGB1 and hs-CRP were negatively correlated with Vaspin, Apelin, Lactobacillus, Bifidobacterium and Escherichia coli (P < 0.05). Binary Logistic regression analysis showed that age over 80 years, AMI, diabetes, hypertension, the number of implanted stents≥3, AFABP, IL-6, HMGB1 and hs-CRP were risk factors for the occurrence of MACE, while Vaspin, Apelin, Lactobacillus, Bifidobacterium and Escherichia coli were the protective factors for the occurrence of MACE (P < 0.05).
Conclusion Patients with coronary heart disease have abnormal expression of serum adipokines, inflammatory factors and intestinal flora after PCI, and there are differences among patients with different types of coronary heart disease. Inflammatory factors are correlated with serum adipokines and intestinal flora. Age, type of coronary heart disease, diabetes, hypertension, the number of implanted stents, adipokines and inflammatory factors as well as intestinal flora indicators are the independent risk factors for the occurrence of MACE after surgery.
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