Correlation Between Traditional Coronary Heart Disease Risk Factors And Index Of Microcirculatory Resistance

Objective To study the relationships between traditional coronary heart disease risk factors and the index of microcirculatory resistance,so as to provide relevant experimental basis for predicting possible coronary artery microvascular dysfunction.Methods A total of 103 patients who were admitted into Hangzhou First People’s hospital from December 2019 to December 2021 were retrospectively involved in this study.The general and clinical information including age,gender,weight,smoking history,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),c-reactive protein and so on were recorded.and the index of microcirculatory resistance(IMR)was determined by pressure guidewire temperature dilution method.With IMR=25 as the critical value.IMR≥ 25 was defined as microcirculation disorder group,IMR<25 was defined as the group without microvascular dysfunction.Statistical analysis was conducted by SPSS 22.0 for Windows and Medcalc Application software to compare the difference of risk factors between the two groups,and finally screen out the risk factors and protective factors related to microvascular dysfunction.Draw and analyze the receiver operating characteristic and nomogram to evaluate microvascular dysfunction and build a prediction model.Result 1.Univariate correlation analysis showed that two groups had significant differences in smoking,aspirin treatment history,serum high-density lipoprotein cholesterol and serum low-density lipoprotein cholesterol(P<0.05).There were no significant differences in age,sex,body mass index,systolic blood pressure,diastolic blood pressure,heart rate,hypertension,diabetes,obstructive coronary artery disease,medical history of beta blockers,angiotensin converting enzyme inhibitor and angiotensin Ⅱ receptor antagonist,diuretic,nitrate,clopidogrel,left ventricular ejection fraction,left ventricular end-diastolic diameter,left end-ventricular systolic diameter,serum urea nitrogen,serum creatinine,serum uric acid,blood glucose,triglyceride,serum total cholesterol,lipoprotein-Al,hypersensitive C-reactive protein and fibrinogen(P>0.05).2.Two categories of logistic regression analysis showed that smoking(B=2.165,OR=98.717,P=0.001)and low-density lipoprotein cholesterol(B=3.136,OR=23.013,P<0.001)are independent risk factors for microcirculatory disorders.Meanwhile,high-density lipoprotein cholesterol(B=-4.264,OR=0.014,P=0.002)is an independent protective factor for microcirculatory dysfunction.The receiver operating characteristic curve and Nomogram will be made based on the regression analysis results to construct a prediction model.The model combined information on smoking,high-density lipoprotein and low-density lipoprotein.The predictive area under curve(AUC)of coronary microcirculation disorders was 0.901(95%confidence interval was 0.827 to 0.951),with a sensitivity of 80.56%and a specificity of 91.04%.Bootstrap method was used for internal verification of the Nomogram with 1000 self-sampling times,the mean absolute error between the predicted value and the actual value was 0.02.Conclusion 1.Among the traditional risk factors of coronary heart disease,smoking and low-density lipoprotein cholesterol are independent risk factors of coronary microvascular dysfunction.2.High-density lipoprotein cholesterol is an independent protective factor for coronary microcirculatory dysfunction,and low-level high-density lipoprotein is a predictor of coronary microvascular dysfunction.