Abstract:We investigated a possible association between the C373G (Leu125Val) polymorphism in the platelet endothelial cell adhesion molecule-1 (PECAM-1) and myocardial infarction (MI) among patients with type 2 diabetes (T2DM) in the Slovene population (Caucasians). The study population of this cross-sectional analysis consisted of 452 subjects with T2DM lasting more than 10 years: 142 patients with MI (MI group) and 310 patients (control group) with no history of coronary diseases. There were significant differences of PECAM-1 genotype distribution in patients with MI (CC=28.2%, CG=47.2% and GG=24.6%) compared with subjects in the control group (CC=17.1%, CG=53.5% and GG=29.4%). The multivariate model showed that the CC genotype of the PECAM-1 gene polymorphism (C373G) (OR=1.9, 95% CI 1.2-3.0, P=0.007) was an independent risk factor for MI. The C allele frequency was also significantly higher (P=0.005) in MI (51.8%) than in control subjects (41%). In addition, our study revealed the connection between smoking habits, the duration of diabetes and the total and LDL cholesterol serum levels and MI in Slovene T2DM patients. We suggest that the tested polymorphism of PECAM-1 (C373G) is associated with MI. Therefore, it might be used as genetic marker of MI in T2DM.

The platelet endothelial cell adhesion molecule 1 (PECAM-1) plays an important role in many inflammatory processes, including the development of atherosclerosis. Polymorphism rs668 of the PECAM-1 gene (373C/G) is functional, and it was reported to be associated with increased serum levels of PECAM-1. We investigated the association between the rs668 polymorphism of PECAM-1 and subclinical markers of carotid atherosclerosis in subjects with type 2 diabetes mellitus (T2DM). Five hundred and ninety-five T2DM subjects and 200 control subjects were enrolled. The carotid intima-media thickness (CIMT) and plaque characteristics (presence and structure) were assessed ultrasonographically. Biochemical analyses were performed using standard biochemical methods. Geno-typing of the PECAM-1 gene polymorphism (rs668) was performed using KASPar assays. The control examinations were performed 3.8 ± 0.5 years after the initial examination. Higher CIMT was found in patients with T2DM in comparison with subjects without T2DM. Statistically sig-nificantly faster progression of the atherosclerotic markers was shown in subjects with T2DM in comparison with the control group. When adjusted to other risk factors, the rs668 GG genotype was associated with an increased risk of carotid plaques in subjects with T2DM. We concluded that our study demonstrated a minor effect of the rs668 PECAM-1 on markers of carotid atherosclerosis in subjects with T2DM.

Metode: Opravili smo retrospektivno raziskavo na zaporednih bolnikih, ki smo jih uvrstili v register PCI. Poleg splošnih značilnosti bolnikov in koronarne anatomije so nas zanimale značilnosti PCI, uporaba žilnih opornic, uspeh PCI in zapleti. Posebej smo obdelali bolnike s PCI na nezaščitenem deblu leve koronarne arterije, ki smo ga opredelili kot pomembno stenozo ob odsotnosti vsaj enega prehodnega kirurškega obvoda.Izsledki: V opazovanem obdobju smo opravili 1.981 PCI. Med bolniki so prevladovali moški (73 %), povprečna starost je bila 65+10 let, večina bolnikov (94 %) pa je imela stabilno koronarno bolezen z večžilno prizadetostjo (62 %). PCI smo opravili na 2.978 stenozah (1,50 stenoze/bolnika) s povprečno zožitvijo 85+10 %. Tarčna sprememba je bila bodisi na levi descendentni koronarni arteriji (42,9 %), desni koronarni arteriji (32,4 %), levi cirkumfleksni arteriji (18,4 %), deblu leve koronarne arterije (3 %), na kirurških obvodih (2,3 %) ali na intermediarni arteriji (1 %). Samo balonsko dilatacijo smo uporabili v 9,6 %, pri ostalih bolnikih pa smo vstavili 1-7 kovinskih žilnih opornic (1,44+0,86/ bolnika). Do leta 2009 je delež žilnih opornic, prevlečenih s citostatikom (DES), znašal 20-30 %, v letu 2012 je porastel na 80 %, v letu 2015 pa na 100 %. PCI je angiografsko uspela v 95,2 %. Zaradi zapleta so 4 bolniki (0,2 %) potrebovali urgentno srčno operacijo, 4 bolniki (0,2 %) pa operacijo na vbodnem mestu. Bolnišnična umrljivost je znašala 0 %. Trombozo žilne opornice v prvih 30 dneh smo ugotovili pri 6 bolnikih (0,3 %). V podskupini 58 bolnikov s PCI nezaščitene stenoze debla leve koronarne arterije smo v 88 % uporabili tehniko s samo eno žilno opornico. Delež DES je bil 94 %. PCI je uspela pri vseh bolnikih. Bolnišnična in 30-dnevna umrljivost sta bili 0 %, enoletna 1,7 % (95-odstotni interval zaupanja 0-11 %), 5-letna pa 13,8 % (95-odstotni interval zaupanja 7-33 %). Potreba po ponovni revaskularizaciji v 5-letnem obdobju je znašala 3,5 % (95-odstotni interval zaupanja 0-23 %).Sklep: PCI pri bolnikih s pretežno stabilno koronarno boleznijo je v Medicorju učinkovita in varna metoda revaskularizacije, kar velja tudi za poseg na nezaščitenem deblu leve koronarne arterije. AbstractBackground: Medicor was established as the third cardiovascular center in Slovenia and started with percutaneous cardiovascular interventions in 2005. The purpose of our study was to describe the features and results of percutaneous coronary intervention (PCI) performed between 2005 and 2015.

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Type-2 diabetes mellitus (DM2) is a major risk factor for the development of coronary artery disease (CAD) and subsequent myocardial infarction (MI). Because the pro-inflammatory cytokine tumor necrosis factor α (TNFα) takes part in several stages of the development of atherosclerosis, we investigated the association of the TNFα gene G(-308)A polymorphism with MI in 142 DM2 patients and in 310 patients who had had DM2 for over 10 years with no clinical signs of CAD and measured the serum TNFα levels in 70 consecutive DM2 patients: 10 with MI and 60 without MI.We found no association between the G(-308)A polymorphism and MI in DM2 [odds ratio (OR) = 0.8, 95% confidence interval (CI) = 0.5-1.3, p = 0.4 for the recessive model and OR = 0.8, 95% CI = 0.2-2.8, p = 0.7 for the dominant model]. Significantly higher TNFα serum levels were found in 58 DM2 patients with the GG genotype compared to 12 with the AG genotype (1.13 ± 0.6 ng/L vs. 0.53 ± 0.35 ng/L, p <0.01). We concluded that the TNFα gene G(-308)A polymorphism is not a risk factor for MI with DM2 in Slovenes of Slavic origin.