Fig. 1Study flow chart. AMI, acute myocardial infarction; PCI, percutaneous coronary intervention; T2DM, type 2 diabetes mellitus; T1DM, type 1 diabetes mellitus; MI, myocardial infarction.
Fig. 2Schema of the measurement of the red blood cell. Elongation index (EI), which was measured at a pressure of 3 Pa, was defined as (L−W)/(L+W) and it was expressed as a percentage. L means the length of the major axis of the cell, and W means the width of the minor axis of the cell. The lower the value of the EI is, the more circular the cell becomes.
Fig. 3Comparison of erythrocyte functions (A, elongation index, P<0.001; B, critical shear stress, P=0.040) between two groups. AMI, acute myocardial infarction. aAMI group showed lower elongation index (A, 30.44%±1.77% vs. 31.47%±1.48%) and higher critical shear stress (B, 316.13±108.20 mPa vs. 286.80±85.34 mPa) compared to control group.
Fig. 4Correlation between the renal function and elongation index at 3 Pa (A, r=0.375, P<0.001; black square, acute myocardial infarction [AMI] group; empty square, non-AMI group) and critical shear stress (B, r=−0.317, P<0.001). GFR, glomerular filtration rate.
Fig. 5Correlation between the elongation index at 3 Pa and critical shear stress (r=−0.124, P=0.090; black square, acute myocardial infarction [AMI] group; empty square, non-AMI group).
Fig. 6Correlation between glycosylated hemoglobin and the elongation index at 3 Pa (r=−0.161, P=0.029; black square, acute myocardial infarction [AMI] group; empty square, non-AMI group).
Table 1Baseline characteristics
Characteristic |
AMI− (n=118) |
AMI+ (n=77) |
P value |
Male sex |
64 (54.2) |
47 (64.4) |
0.167 |
Age, yr |
63.28±8.88 |
65.47±9.15 |
0.098 |
BMI, kg/m2
|
24.33±2.85 |
23.55±3.04 |
0.071 |
Systolic blood pressure, mm Hg |
130.12±14.13 |
133.22±27.93 |
0.369 |
Current smoker |
21 (17.8) |
14 (19.2) |
0.810 |
Hypertension |
70 (59.3) |
35 (47.9) |
0.125 |
Cerebrovascular accident |
8 (6.8) |
5 (6.8) |
0.985 |
LV ejection fraction |
64.00±4.33 |
47.68±10.21 |
<0.001 |
E/E′; ratio |
12.48±3.96 |
14.01±6.49 |
0.173 |
RWMI |
1.00±0.01 |
1.41±0.32 |
<0.001 |
Table 2Laboratory findings
Variable |
AMI− (n=118) |
AMI+ (n=77) |
P value |
WBC count, K/µL |
7.38±2.77 |
10.68±3.57 |
<0.001 |
Hemoglobin, g/dL |
13.53±1.81 |
13.11±2.15 |
0.164 |
RDW, % |
13.15±0.87 |
13.75±1.30 |
<0.001 |
MCV, fL |
90.36±3.73 |
90.70±3.75 |
0.551 |
MCHC, g/dL |
33.95±1.03 |
34.14±0.83 |
0.180 |
Platelet count, K/µL |
253.52±80.07 |
225.12±66.36 |
0.011 |
ESR, mm/hr |
27.48±32.03 |
23.31±19.16 |
0.454 |
hs-CRP, mg/dL |
1.81±3.42 |
3.15±4.25 |
0.071 |
Creatinine, mg/dL |
1.07±0.34 |
1.85±1.78 |
0.001 |
Estimated GFR, mL/min |
73.62±17.30 |
54.16±22.63 |
<0.001 |
Total cholesterol, mg/dL |
184.35±42.30 |
188.61±50.90 |
0.536 |
Triglyceride, mg/dL |
160.46±108.61 |
171.29±109.82 |
0.512 |
HDL, mg/dL |
50.38±14.48 |
42.17±13.45 |
<0.001 |
LDL, mg/dL (estimated) |
101.99±34.78 |
112.18±45.16 |
0.106 |
Cystatin C, mg/dL |
0.84±0.28 |
1.19±1.05 |
0.024 |
Uric acid, mg/dL |
5.06±1.81 |
5.76±1.62 |
0.029 |
Total protein, mg/dL |
7.27±0.66 |
6.44±0.68 |
<0.001 |
Total bilirubin, mg/dL |
0.78±0.26 |
0.90±0.33 |
0.006 |
AST, IU/L |
26.83±13.90 |
39.04±27.77 |
<0.001 |
ALT, IU/L |
27.03±18.19 |
26.59±14.45 |
0.858 |
Fasting glucose, mg/dL |
164.40±53.39 |
155.61±48.67 |
0.362 |
Fasting insulin, µU/mL |
12.75±23.18 |
14.32±17.96 |
0.713 |
Fasting C-peptide, ng/mL |
2.90±3.12 |
3.33±2.13 |
0.366 |
Glycosylated hemoglobin, % |
7.89±1.76 |
7.82±1.61 |
0.781 |
HOMA-β |
53.71±106.75 |
66.29±57.36 |
0.476 |
HOMA-IR |
3.80±2.17 |
6.19±11.22 |
0.189 |
Table 3The association between critical shear stress and erythrocyte sedimentation rate or dipeptidyl peptidase-4 inhibitors on multiple linear regression
Variable |
R2
|
Estimated β |
Standard error |
P value |
Erythrocyte sedimentation rate |
0.497 |
3.644 |
0.734 |
<0.001 |
Dipeptidyl peptidase-4 inhibitors |
0.574 |
−64.215 |
30.872 |
0.048 |