The Application Of GRACE Score Complements The Brachial-ankle Pulse Wave Velocity, Plasma Fibrinogen In People With Acute Coronary Syndrome

Objectives:This study was designed to investigate the global registry of acute coronary events score, brachial ankle pulse wave velocity and plasma fibrinogen and predict its value of the severity of coronary artery lesions in patients with acute coronary syndrome; whether baPWV, plasma FIB can be used as an early screening index and predictive value for acute coronary syndrome patients.Method:1. A total of 189 patients were taken into this study, and all the patients came from The cardiovascular department of The First Affiliated Hospital of Kunming Medical University from 2013 December to 2014 October2. Participants’basic data, including Demographic characteristics, tobacco and alcohol addiction, past medical history, family history of heart disease, clinical manifestations and disease diagnosis were collected during their admission.3. According to the clinical diagnosis, the patients were divided into unstable angina pectoris(UA), non ST elevation myocardial infarction (NSTEMI) and ST segment elevation myocardial infarction (STEMI). And according to the results of coronary angiography were divided into single vessel disease group, double vessel lesion group and three vessel disease group.4. All patients were calculated the GRACE score, anddivided into high risk group, medium risk group, low risk group according to the Grace score; measured the baPWV, FIB level and did coronary angiography.5. Statistical analyses were performed by SPSS 21.0 software package.Comparison the differences between the groups about GRACE score, baPWV, and plasma FIB; building Logistic regression model to analyze whether there is a linear relationship between baPWV, plasma FIB and other indicators; Through the analysis of the ROC to predict the early value of acute coronary syndrome about plasma FIB and baPWV.With P< 0.05 were statistically been significant differences.Results:1. Male, history of hypertension significantly affected coronary artery disease; FIB and baPWV higher in ACS group than the control group(P< 0.001);2. The score of Grace, baPWV, FIB in STEMI group, NSTEMI group was significantly higher than that of UA group(P< 0.05),While the STEMI group was higher than NSTEMI group, but the difference was not statistically significant (P> 0.05);3. The plasma FIB, baPWV was higher in high risk group patients than that in the middle risk group patients and low risk group patients,and the plasma FIB, baPWV was higher in middle risk group patients than that in the low risk group patients (P< 0.05);4. The score of Grace, baPWV, FIB in three vessel disease group patients was higher than that of patients with double vessel group patients and single vessel disease group, and the score of Grace, baPWV, FIB in double vessel disease group patients was higher than that of patients with single vessel disease group (P< 0.05);5.There was a mild positive correlation between vessual lesions and Grace score (rs=0.238, P<0.05),a moderate positive correlation between lesions and plasma FIB (rs=0.690, P<0.001), a moderate positive correlation between lesions and baPWV (rs=0.666, P< 0.001), FIB was positively related with baPWV (r=0.707, P < 0.001); 6.FIB predict ROC curve area of acute coronary syndrome was 0.741 (P< 0.001), sensitivity and specificity were 58.6% and 77.3%,baPWV predict ROC curve area of acute coronary syndrome was 0.736 (P< 0.001),sensitivity and specificity were 55.9% and 84.1%; 7.The Acute coronary syndrome as the dependent variable, multiple factor non conditional Logistics regression analysis showed that independent risk and acute coronary syndrome associated morbidity factor is plasma FIB and male(OR= 10.133,2.780).Conclusions:1. The plasma FIB and baPWV increased with Grace score, and can be used as auxiliary risk evaluation index in ACS patients;2. The score of Grace, plasma FIB and baPWV increased with the severity of coronary artery disease, and can reflect the severity of coronary artery disease;3. combination of Grace score, FIB and baPWV can improve the detection rate of acute coronary syndrome;4. baPWV and plasma FIB has an important predictive value of ACS patients by Description of ROC curve with baPWV and plasma FIB,and can be used as early screening index;5. Logistics regression analysis showed that male, FIB are independent risk factors for acute coronary syndrome.