AIM To investigate the activation level of transient receptor potential cation channel subfamily V member 1 (TRPV1) in patients of coronary heart disease combined with diabetes and its correlation with the expressions of inflammatory factors and evaluate its risk value for major adverse cardiovascular events (MACEs).
METHODS From October 2022 to October 2023, 60 patients with chronic stable angina pectoris complicated with type 2 diabetes (combined group), 60 patients with angina pectoris alone, 60 patients with diabetes alone, and 60 healthy controls were selected consecutively. Western blot was used to detect the expression level of TRPV1 in peripheral blood monocytes, and ELISA was used to detect serum concentrations of tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin-2 (IL-2), IL-6, IL-10, monocyte chemotactic protein-1 (MCP-1) and macrophage inflammatory protein (MIP)-2. The median follow-up time in the combined group after discharge was 12.5 months and MACEs (mainly including malignant arrhythmias, acute heart failure attacks, cardiac function deterioration to stage D, sudden cardiac death, etc.) were recorded.
RESULTS Compared with the control group, the fasting blood glucose and glycosylated hemoglobin in the diabetes group and the combined group increased. There was no significant difference between the two groups, but both were higher than those in the angina pectoris group (both P<0.01). Compared with the control group, the levels of TNF - α, IFN - γ, IL-2, IL-6, IL-10, MCP-1, MCP-2 and TRPV1 in the diabetes group, angina pectoris group and the combination group were higher than those in the diabetes group and angina pectoris group (both P<0.01), but there was no significant difference between diabetes group and angina pectoris group. Pearson test showed that TRPV1 levels were positively correlated with the concentrations of TNF - α, IFN - γ, IL-2, IL-6, IL-10, MCP-1, and MIP-2 (both P<0.01). Six cases of MACE (10%) were recorded in the merged group. Multivariate logistic regression showed that TRPV1 level was an independent predictor of MACEs (OR=2.913,95% CI: 2.462~3.423, P<0.05). ROC curve showed that the area under the curve (AUC) predicted by TRPV1 activation level for the occurrence of MACEs in patients with chronic stable angina pectoris and diabetes at 1 year follow-up was 0.856 (95% CI: 0.801~0.923, P<0.01).
CONCLUSION TRPV1 may be over activated in patients of coronary heart disease complicated with diabetes, which is closely related to the high expressions of multiful inflammatory factors and the risk of MACEs during 1 year follow-up. TRPV1 is expected to become an important non-invasive biochemical marker for predicting clinical prognosis.
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