Relationship between clinical features, peripheral microcirculatory and severity of coronary artery disease in patients with coronary heart disease

doi:10.3969/j.issn.1004-583X.2022.02.004

Abstract

Abstract:

Objective To explore the relationship between clinical features, peripheral microcirculatory and the severity of coronary artery disease (CAD) in patients with coronary heart disease (CHD).Methods Totally 220 CHD patients admitted to our hospital from March 2016 to March 2021 were assigned into mild and moderate group (n=142) and severe and extremely severe group (n=78). The data of age, gender, body mass index (BMI), diabetes mellitus (DM), and hypertension on admission were collected; the indicators of the two groups were measured on day 1 admission, including folic acid (FA), vitamin B₁₂ (VB₁₂), total bilirubin (TBIL), triglyceride (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). The rewarming test of finger skin was used to measure peripheral microcirculatory; the predictive value of FA, VB₁₂, TBIL, TC, LDL-C, RT for severe and extremely severe CAD in CHD patients was analyzed according to receiver operating characteristic (ROC) curve by comparing the basic data, laboratory index, finger rewarming time (RT) of two groups. The different single factors were included in the Logistic model and quantified to determine the risk factors of severe and extremely severe CAD in CHD patients.Results Compared with mild and moderate group, the proportion of patients with age≥60 and hypertension in severe and extremely severe group was significantly increased; FA, VB₁₂ and TBIL in severe and extremely severe group were significantly decreased; TC, LDL-C and RT were obviously higher; and with statistically significant difference (P<0.05). The areas under curve (AUC) of FA, VB₁₂, TBIL, TC, LDL-C and RT in predicting in the pathogenesis of severe and extremely severe CAD in CHD patients were 0.931, 0.732, 0.869, 0.849, 0.775 and 0.967, respectively (all P<0.05). Multivariate Logistic regression analysis showed that the risk factors of severe and extremely severe CAD in CHD patients were age≥60 years old, hypertension, FA≤6.555 μg/L, VB₁₂≤268.295 ng/L, TBIL≤10.015 μmol/L, TC≥5.015 mmol/L, LDL-C≥2.680 mmol/L, RT≥405.240 s.Conclusion Patients with age≥60 years old and hypertension are more likely to have severe and extremely severe CAD. The levels of FA, VB₁₂, TBIL, TC, LDL-C and peripheral microcirculatory are closely correlated with severity of CAD, which can be used to evaluate the severity of patients.

Key words: coronary heart disease, clinical features, peripheral microcirculation, degree of coronary artery disease

CLC Number:

R541.4

Duan Liqin. Relationship between clinical features, peripheral microcirculatory and severity of coronary artery disease in patients with coronary heart disease[J]. Clinical Focus, 2022, 37(2): 119-123.

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URL: http://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2022.02.004

http://www.lchc.cn/EN/Y2022/V37/I2/119

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References 18

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项目	轻、中度组 (n=142)	重、极重度组 (n=78)	t/χ²值	P值
年龄[例(%)]
<60岁 ≥60岁	88(61.97) 54(38.03)	29(37.18) 49(62.82)	12.429	0.000
性别[例(%)]
男女	77(54.23) 65(45.77)	43(55.13) 35(44.87)	0.017	0.898
BMI(kg/m²)	24.21±3.54	24.68±3.51	0.945	0.346
糖尿病[例(%)]
是否	37(26.06) 105(73.94)	25(32.05) 53(67.95)	0.894	0.344
高血压[例(%)]
是否	61(42.96) 81(57.04)	46(58.97) 32(41.03)	5.170	0.023
FA(μg/L)	7.86±2.15	5.15±1.64	9.688	0.000
VB₁₂(ng/L)	289.42±67.67	256.86±68.51	3.399	0.001
TBIL(μmol/L)	11.84±3.14	8.67±2.31	7.825	0.000
TG(mmol/L)	2.35±0.54	2.43±0.57	1.031	0.304
TC(mmol/L)	4.38±1.01	5.15±1.13	5.184	0.000
HDL-C(mmol/L)	1.31±0.32	1.28±0.34	1.491	0.137
LDL-C(mmol/L)	2.48±0.52	2.87±0.57	5.142	0.000
RT(s)	361.45±43.85	432.15±50.42	10.840	0.000

项目	轻、中度组 (n=142)	重、极重度组 (n=78)	t/χ²值	P值
年龄[例(%)]
<60岁 ≥60岁	88(61.97) 54(38.03)	29(37.18) 49(62.82)	12.429	0.000
性别[例(%)]
男女	77(54.23) 65(45.77)	43(55.13) 35(44.87)	0.017	0.898
BMI(kg/m²)	24.21±3.54	24.68±3.51	0.945	0.346
糖尿病[例(%)]
是否	37(26.06) 105(73.94)	25(32.05) 53(67.95)	0.894	0.344
高血压[例(%)]
是否	61(42.96) 81(57.04)	46(58.97) 32(41.03)	5.170	0.023
FA(μg/L)	7.86±2.15	5.15±1.64	9.688	0.000
VB₁₂(ng/L)	289.42±67.67	256.86±68.51	3.399	0.001
TBIL(μmol/L)	11.84±3.14	8.67±2.31	7.825	0.000
TG(mmol/L)	2.35±0.54	2.43±0.57	1.031	0.304
TC(mmol/L)	4.38±1.01	5.15±1.13	5.184	0.000
HDL-C(mmol/L)	1.31±0.32	1.28±0.34	1.491	0.137
LDL-C(mmol/L)	2.48±0.52	2.87±0.57	5.142	0.000
RT(s)	361.45±43.85	432.15±50.42	10.840	0.000

指标	曲线下面积	标准误	95%可信任区间	最佳截断值	敏感度	特异度
FA	0.931	0.016	0.900~0.962	6.555	0.754	0.987
VB₁₂	0.732	0.034	0.665~0.799	268.295	0.655	0.590
TBIL	0.869	0.024	0.822~0.916	10.015	0.739	0.832
TC	0.849	0.027	0.796~0.902	5.015	0.679	0.789
LDL-C	0.775	0.031	0.713~0.837	2.680	0.756	0.669
RT	0.967	0.023	0.846~0.937	405.240	0.692	0.944

指标	曲线下面积	标准误	95%可信任区间	最佳截断值	敏感度	特异度
FA	0.931	0.016	0.900~0.962	6.555	0.754	0.987
VB₁₂	0.732	0.034	0.665~0.799	268.295	0.655	0.590
TBIL	0.869	0.024	0.822~0.916	10.015	0.739	0.832
TC	0.849	0.027	0.796~0.902	5.015	0.679	0.789
LDL-C	0.775	0.031	0.713~0.837	2.680	0.756	0.669
RT	0.967	0.023	0.846~0.937	405.240	0.692	0.944

变量		量化赋值
年龄	X1	≥60岁=1, <60岁=0
高血压	X2	是=1,否=0
FA	X3	≤6.555 μg/L=1,>6.555 μg/L=0
VB₁₂	X4	≤268.295 ng/L=1,>268.295 ng/L=0
TBIL	X5	≤10.015 μmol/L=1,>10.015 μmol/L=0
TC	X6	≥5.015 mmol/L=1,<5.015 mmol/L=0
LDL-C	X7	≥2.680 mmol/L=1,<2.680 mmol/L=0
RT	X8	≥405.240 s=1,<405.240 s=0
冠状动脉病变程度	Y	重、极重度=1,轻、中度=0