非ST段抬高急性冠脉综合征患者H2FPEF评分与SYNTAX评分的关系

The relationship between H2FPEF Score and SYNTAX scores in patients with non-ST segment elevation acute coronary syndrome

目的探讨非ST段抬高急性冠状动脉(冠脉)综合征患者H2FPEF评分与SYNTAX评分的关系。方法纳入2019年1月至2019年12月因胸痛于郑州大学第二附属医院心血管内科住院治疗,并行冠状动脉(冠脉)造影,确诊为NSTE-ACS患者118例,入院时计算每例患者的H2FPEF值,使用SYNTAX评分系统评估冠脉病变程度,依据SYNTAX评分,将患者分为低SYNTAX评分组(低SYNTAX Score组,简称低SS组)和高SYNTAX评分组(高SYNTAX Score组,简称高SS组)。采用Logistic回归方法及受试者工作特征(ROC)曲线分析非ST段抬高急性冠脉综合征患者高SYNTAX评分的相关影响因素。采用pearson法对H2FPEF评分与SYNTAX评分进行相关性分析。结果高SS组患者平均年龄明显高于低SS组,高SS组患者的糖尿病、高血压和心房颤动(房颤)的比例及体质指数(BMI)明显高于低SS组(P<0.05)。两组患者在性别、吸烟史方面上,差异无统计学意义;相关性分析显示,H2FPEF评分与SYNTAX评分呈显著正相关(r=0.828,P<0.001)。多因素logisitic回归分析显示,H2FPEF评分(OR=6.547,95%CI:3.090~13.869,P<0.001)和左室射血分数(OR=0.818,95%CI:0.750~0.892,P=0.036)被发现是SS评分高的独立预测因素。ROC曲线分析显示,H2FPEF评分取界值为3.5时,预测SS评分较高的准确性最佳,敏感性为84.6%,特异性为88.6%(AUC=0.926,95%CI:0.880~0.971,P<0.001)。结论非ST段抬高急性冠脉综合征患者H2FPEF评分与SYNTAX评分呈显著正相关,可用于评估NSTE-ACS患者的病变程度及复杂性。

Objective To investigate the relationship between H2FPEF Score and SYNTAX scores in patients with non-ST segment elevation acute coronary syndrome.Methods 118 patients with NSTE-ACS diagnosed by coronary angiography in the Department of cardiovascular medicine of the Second Affiliated Hospital of Zhengzhou University in 2019 due to chest pain were enrolled in this study.The H2FPEF Score of each patient was calculated on admission,and the severity and extent of CAD were assessed using the SYNTAX scoring system.According to syntax score,the patients were divided into low SYNTAX score group(Low SS group)and high SYNTAX score group(High SS group).Logistic regression and receiver operating characteristic(ROC)curve were used to analyze the influencing factors of the high SYNTAX score in patients with non-ST segment elevation acute coronary syndrome.The Pearson method was used to analyze the correlation betweenH2FPEF score and SYNTAX scores.Results The average age of patients in the high SS group was significantly higher than that in the low SS group.The prevalence of diabetes,hypertension and atrial fibrillation in the high SS group and BMI were significantly higher than those in the low SS group.The difference was statistically significant.There was no significant difference in gender and smoking history between the two groups;Correlation analysis showed a significant positive correlation between H2FPEF score and SYNTAX scores(r=0.828,P<0.001).Multivariate Logistic regression analysis showed that H2FPEF Score(OR=6.547,95%CI:3.090~13.869,P<0.001)and low left ventricular ejection fraction(OR=0.818,95%CI:0.750~0.892;P=0.036)were found to be independent predictors of high SS score.ROC curve analysis showed that when the cut off value of the H2FPEF Score was 3.5,the predictive SS score was higher,the sensitivity was 84.6%,and the specificity was 88.6%(AUC:0.926,95%CI:0.880~0.971,P<0.001).Conclusion there was a significant positive correlation between the H2FPEF Score and SYNTAX scores in patients with non-ST elevation segment acute coronary syndrome,which can be used to evaluate the severity and complexity of NSTE-ACS.