BACKGROUND: To study the distribution of the polymorphism of apo E and angiotensin converting enzyme genotypes in type 2 diabetic patients and to evaluate possible association between the apo E genotypes and angiotensin converting enzyme genotypes and intima-media thickness of the common carotid artery. METHODS: Study participants were 206 type 2 diabetic patients (112 men and 94 women), aged 18-81 years. HbA1C, albuminuria, and lipid status were assessed by standard laboratory techniques ; the apo E genotypes were assessed by modified amplification refractory mutation system of polymerase chain reaction technique and the angiotensin converting enzyme genotypes were assessed by multiplex polymerase chain reaction technique. The intima-media thickness was measured by high-resolution ultrasonography. RESULTS: The apo E allele frequencies of patients were E2 11%, E3 72%, and E4 17%. Mean HDL-cholesterol was lower in E4 carrier (n=35) than E2 (n=148) and E3 (n=35) carrier. E2 carriers has less common carotid intima-media thickness than E3 and E4 carriers (p< 0.05). The angiotensin converting enzyme genotypes were distributed as follows ; II 38%, ID 47%, DD 15%. The intima-media thickness value did not differ among patients with various genotypes. Multiple logistic regression analysis showed that only apo E polymorphism was determinant for the intima-media thickness. CONCLUSION: Our results suggested that apo E polymorphism was associated with carotid artery intima-media thickness in type 2 diabetic patients. But we could not find an association between carotid artery intima-media thickness and angiotensin converting enzyme genotype in this patients population.
Albuminuria ; Angiotensins* ; Apolipoproteins E ; Apolipoproteins* ; Carotid Arteries* ; Carotid Artery, Common ; Carotid Intima-Media Thickness ; Diabetes Mellitus* ; Gene Frequency ; Genotype ; Humans ; Logistic Models ; Male ; Multiplex Polymerase Chain Reaction ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Ultrasonography

BACKGROUND AND OBJECTIVES: The combination of platelet glycoprotein IIb/IIIa inhibitors and a low dose thrombolytic agent may produce early Thrombolysis In Myocardial Infarction (TIMI) 3 flow and a high rate of ST elevation resolution in an ST elevation acute myocardial infarction (STEMI). The clinical effect of tirofiban combined with low dose alteplase, prior to primary percutaneous coronary intervention (PCI) in STEMI, were evaluated on the ST elevation resolution, TIMI flow and 30-day clinical outcomes. SUBJECTS AND METHODS: Following aspirin, clopidogrel and standard heparin, 45 patients with STEMI were randomized into 2 groups; tirofiban administration (Group I; n=23, 64+/-10 years; 15 male) or combined administration of tirofiban with 40 mg alteplase prior to primary PCI (Group II; n=22, 59+/-11 years; 19 male). The pre- and post-interventional TIMI flow grades, ST elevation resolution and bleeding complications were compared between the two groups. The major adverse cardiac events (MACE) were compared between the two groups during 30-days of clinical follow-up. RESULTS: Group II had a higher pre-interventional TIMI flow (TIMI flow> or =2: 34.8% vs. 90.9%, p<0.0001) and rate of ST elevation resolution (49.0+/-27.8% vs. 66.6+/-27.2%, p=0.045) than Group I. A major bleeding complication developed in 1 (5.0%) Group II patient, and minor bleeding complications developed 1 patient from each group (Group I; 9.5% vs. Group II; 10%, p=0.959). CONCLUSION: Combined administration of tirofiban with alteplase prior to primary PCI leads to a higher TIMI flow and more frequent ST elevation resolution, without bleeding complications, compared to a single administration of tirofiban.
Angioplasty ; Aspirin ; Blood Platelets ; Electrocardiography ; Follow-Up Studies ; Glycoproteins ; Hemorrhage ; Heparin ; Humans ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Thrombolytic Therapy ; Tissue Plasminogen Activator*