Association Between Carotid Atherosclerosis And Severity Of Coronary Artery Disease In Patients With ACS

OBJECTIVE: By studying the correlation between the ultrasonic manifestations of carotid atherosclerosis and the severity of coronary artery disease in ACS patients,the clinical value of predicting coronary artery disease by carotid atherosclerosis was discussed.METHODS: 130 patients with "coronary heart disease" to be diagnosed in the department of cardiology of zibo district hospital from July 2016 to June 2017 were selected,including 94 ACS patients,including 32 acute myocardial infarction(AMI)and 62 unstable angina pectoris(UA),and 36 chest pain patients with normal coronary angiography and clinical exclusion of coronary heart disease as the control group.Application of carotid artery ultrasound in patients with acute myocardial infarction(AMI),unstable angina,and coronary angiography in patients with normal and combined with clinical rule out the chest pain of coronary heart disease(CHD)patients(control group)of the echo of the carotid atherosclerosis plaque type and shape,intima-media thickness(IMT)and calculate the Crouse integral,IMT between ACS group and control group,the differences of Crouse integral;According to the degree of coronary artery stenosis,the above patients were divided into three groups: non-stenosis group(n=38),mild stenosis group(n=18),moderate stenosis group(n=38)and severe stenosis group(n=36).The differences in IMT and Crouse scores were compared.According to the number of coronary artery lesions,the above patients were divided into non-stenosis group(n=38),single-vessel lesion group(n=22),double-vessel lesion group(n=22)and multi-vessel lesion group(n=48),and the differences in IMT and Crouse scores were compared.To compare the difference between the degree of coronary artery stenosis and the detection of different carotid artery plaque morphology,and the difference between ACS and the control group in the detection of different carotid artery plaque morphology;The severity of coronary artery was evaluated by Gensini score,and the correlation between the IMT and Crouse scores of all the above patients and Gensini score was analyzed,so as to obtain the correlation between carotid atherosclerosis and the degree of coronary atherosclerosis stenosis.Measurement data to ((?)±s)carries on the statistical description,using T test for all conform to the normal distribution of quantitative data items(IMT),crouse integral statistically analyzed,the qualitative data of all accord with normal distribution project chi-square test was used to statistically analyze,use simple linear regression linear correlation of two groups of two sets of quantitative data analysis.RESULTS: 1.The IMT value [(1.78±0.21)mm ratio(0.92±0.23)mm,P<0.05] and crouse score [5.21±0.62 ratio 1.16 0.92,P<0.05] of the ACS group were higher than that of the control group.2.The IMT value [(1.81±0.32)mm ratio(1.51±0.26)mm ratio(0.94±0.25)mm,P<0.05)and crouse score [5.21±1.21 ratio 3.68±0.15 ratio 1.17±0.85,P<0.05] of the moderate and severe coronary artery stenosis group were significantly higher than that of the mild stenosis group and the non-stenosis group.The IMT [(1.51±0.26)mm ratio(0.94 ±0.25)mm,P<0.05] and crouse score [3.68±0.15 ratio 1.17±0.85,P<0.05] of the mild stenosis group were higher than that of the non-stenosis group.3.The IMT[(1.96±0.35)mm ratio(1.71±0.21)mm ratio(1.53±0.23)and crouse score [5.82±1.04 ratio 4.58±0.24 ratio 3.72±0.12,P<0.05] of the multi-vessel coronary artery disease group were higher than those of the double-vessel disease group and the single-vessel disease group.The IMT[(1.71±0.21)mm ratio(0.94±0.25),P<0.05] and Crouse score [4.58±0.24 ratio 1.17±0.85,P<0.05] of the dual-vessel lesion group were higher than that of the non-stenosis group.4.The detection rate of unstable plaques in the moderate and severe coronary artery stenosis group was higher than that in the mild stenosis group and the non-stenosis group [94.59% vs.38.89% vs.21.05%,P<0.05].The ACS group had a higher detection rate of unstable plaques [85.11% vs.19.44%,P<0.05] than the control group.5.Gensini score was significantly correlated with IMT(R=0.956,P<0.001)and Crouse score(R=0.968,P<0.001).CONCLUSIONS: 1.The severity of carotid atherosclerosis is closely related to the occurrence of ACS.2.IMI value and Crouse integral of carotid artery can indirectly reflect the severity of coronary artery lesions,not only in the degree of coronary artery stenosis,but also in the extent of coronary artery lesions and the number of lesion branches.3.The existence of unstable carotid plaques is closely related to the severity of coronary artery disease and the occurrence of ACS,which indicates that the incidence of acute coronary events increases.4.The degree of carotid atherosclerosis and the detection and classification of plaques have predictive value for the degree of coronary artery lesions in ACS patients.