Changes of plasma Big ET-1,SIRT1 and CXCL12 in the patients with ACS and T2DM and their correlation with coronary artery disease

Hao Jia; Wang Huifeng; Zhang Qiang; Liu Feijun; Ma Huirong

doi:10.3969/j.issn.1002-1949.2025.02.004

Abstract：Objective To explore the changes of plasma big endothelin-1(Big ET-1),silent information regulator 1(Sirtuin-1,SIRT1)and CXC chemokine ligand 12(CXCL12)in the patients with acute coronary syndrome(ACS)complicated with type 2 diabetes mellitus(T2DM)and their correlation with coronary artery disease.Methods A total of 100 patients with ACS complicated with T2DM in General Hospital of Taiyuan Iron and Steel(Group)Company Limited from March 2021 to March 2023 were selected as the study group,and 100 non-diabetic patients with ACS were selected as the control group during the same period.Plasma levels of Big ET-1,SIRT1 and CXCL12 were compared between the two groups,as well as clinical data,plasma levels of Big ET-1,SIRT1 and CXCL12 of patients with different degrees of coronary artery disease in the study group,and the influencing factors of the severity of coronary artery disease in ACS patients complicated with T2DM were analyzed.The value of plasma levels of Big ET-1,SIRT1 and CXCL12 in evaluating the severity of coronary lesions in ACS patients complicated with T2DM was analyzed,and plan A[family history of coronary heart disease,serum homocysteine(Hey),proprotein convertase subtilisin/kexin type9(PCSK9)levels,left ventricular ejection fraction(LVEF),plasma Big ET-1,SIRT1 and CXCL12 joint evaluation]and plan B(family history of coronary heart disease,serum Hcy,PCSK9 and LVEF joint evaluation)were compared.Results Plasma levels of Big ET-1,SIRT1 and CXCL12 in study group were higher than those in control group(P＜0.05).The family history of coronary heart disease,plasma Big ET-1,SIRT1 and CXCL12 levels in severe patients were higher than those in mild patients,and LVEF was lower than those in mild patients(P＜0.05).Family history of coronary heart disease,serum Hcy,PCSK9 levels,plasma Big ET-1,SIRT1 and CXCL12 levels were independent risk factors for the severity of coronary artery disease in ACS patients complicated with T2DM,and LVEF was a protective factor(P＜0.05).The area under curve(AUC)of plasma Big ET-1,SIRT1 and CXCL12 for assessing the severity of coronary artery disease in ACS patients complicated with T2DM was 0.741,0.751 and 0.789,respectively.AUC assessed by plan A was 0.942(95％CI 0.876-0.979),which was higher than AUC of 0.859(95％CI 0.775-0.921)assessed by plan B(P＜0.05).Conclusions Plasma Big ET-1,SIRT1 and CXCL12 are closely related to ACS complicated with T2DM,which provides a reference for early clinical evaluation and prediction of the degree of coronary artery disease,so as to carry out targeted follow-up treatment and improve the prognosis.