| Objective: The clinical data of patients with acute coronary syndromes(ACS)in our hospital during a period of time were retrospectively analyzed to study the risk factors related to the formation of collateral circulation and the influence of collateral circulation on the prognosis of patients with ACS,so as to explore the clinical significance of risk factors and the formation of collateral circulation.Methods: From January 2015 to January 2019,145 patients diagnosed with acute coronary syndrome were hospitalized in the department of cardiovascular medicine of our hospital.All patients were divided into group A and group B according to the results of angiography.The patients with grade Rentrop0,i.e.,those without collateral circulation,were in group A.Rentrop1,2,and 3,i.e.,the collateral cyclones are group B.After admission,the patient’s medical history was inquired and basic information was collected,such as past history,family history,medication history,surgical history,etc.,among which past history included the history of hypertension,diabetes,smoking history and the history of angina before the onset.Then the 12-lead electrocardiogram,laboratory examination(biochemical examination,SCRP,c Tn I,etc.)and cardiac color doppler ultrasound were improved.At the time of admission,the blood routine,SCRP,c Tn I and other laboratory tests were completed for each patient,and the next day,the biochemical test,fasting blood glucose test and cardiac ultrasound were completed.Within 12±2 months after discharge,he/she came to the hospital for reexamination and angiography to improve cardiac ultrasound.During the statistical period,there were no major adverse cardiac events and complications of acute myocardial infarction.Results: 1.The incidence of major adverse cardiac events(recurrent angina,acute myocardial infarction,coronary revascularization,and coronary death)within 12±2months in the two groups(52.1% VS 15.7%)and the incidence of post-myocardial infarction complications(24.5% VS 7.8%)were statistic difference between the two groups(p < 0.05).2.There were statistically significantly different in smoking history(53.2% VS 35.3%),Gensini score(88.65±5.44 VS 115.18±4.38),median SCRP(3.00 VS 5.30),median c TNI(1.03 VS 0.68)and median uric acid(342 VS 379)between the two groups(p < 0.05).Logistic regression analysis of the above factors showed that smoking,uric acid and Gensini scores were the related factors of collateral circulation shape(p < 0.05).According to ROC curve analysis,Gensini score was used as the influencing factor to predict the formation of collateral circulation.The cut-off point was 73.5,the specificity was 0.961,and the sensitivity was 0.596.Conclusion: 1.The formation of coronary collateral circulation can reduce the occurrence of recent post-myocardial infarction complications and major adverse cardiac events in patients with ACS.2.Smoking was the main influencing factor for the formation of collateral circulation,and uric acid and Gensini scores were the secondary influencing factors for the formation of collateral circulation.3.Gensini score has certain reference value for clinicians to judge whether patients with ACS have formed collateral circulation in the early stage. |
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