Study On The Relationship Between FAR,NPAR And Non-ST-segment Elevation Myocardial Infarction And The Severity Of Coronary Artery Disease

Objective:Non-ST-segment elevation myocardial infarction(NSTEMI)is a cardiovascular disease with acute onset,high mortality and many complications.It has a great impact on national health and social development.Therefore,timely diagnosis and appropriate treatment are very important.Although the plasma fibrinogen/albumin ratio(FAR)and the percentage of neutrophils/albumin ratio(NPAR)have been confirmed to be related to the prognosis of coronary heart disease and adverse cardiovascular events,the research on the relationship between FAR,NPAR and NSTEMI is still insufficient.As inflammatory markers,FAR and NPAR have the advantages of easy detection,low cost and strong feasibility in clinic.Therefore,they can be used to evaluate the risk stratification of NSTEMI,assist diagnosis and guide clinical treatment.Therefore,the purpose of this study is to study the relationship between FAR,NPAR and NSTEMI,and explore the relationship between them and the severity of coronary artery disease of NSTEMI.This study can provide a basis for the diagnosis and treatment of cardiovascular diseases.Methods:125 patients with non-ST-segment elevation myocardial infarction diagnosed by coronary angiography(CAG)in the Department of Cardiology of the Second Clinical Hospital of Shanxi Medical University due to acute chest pain from March 1,2020 to December 31,2021 were retrospectively collected as NSTEMI group,which met the diagnostic criteria of NSTEMI in 2020esc guidelines for non ST segment elevation acute coronary syndrome.82 patients with suspected coronary heart disease admitted to the Department of Cardiology of our hospital in the same period and normal coronary artery confirmed by CAG were used as the control group.The basic data,various laboratory indexes and examination results of all patients were collected and spss21.0 was used 0 sort out and analyze the collected data,and compare the differences between the two groups by means of mean±standard deviation,t-test,x~2test and Mann-Whitney U test;Multivariate logistic regression analysis was used to analyze the independent influencing factors of NSTEMI;Draw receiver operating characteristic curve(ROC)to analyze the diagnostic value of FAR and NPAR for NSTEMI;Pearson correlation was used to analyze the correlation between FAR,NPAR and the degree of coronary artery stenosis in NSTEMI patients.The difference was statistically significant(P<0.05).Results:1.the basic data showed that the age,sex(male),heart rate,history of hypertension,history of type 2 diabetes,smoking and drinking of the two groups had statisticalsignificance(P<0.05).There was no significant difference in body mass index,family history of coronary heart disease,first admission systolic blood pressure and firstadmission diastolic blood pressure between the two groups(P>0.05);2.The laboratory data showed that the percentage of leukocytes,hemoglobin,platelets,medium and fine-grained cells,fibrinogen,serum albumin,aspartateaminotransferase,creatinine,high-density lipoprotein,fasting blood glucose,left ventricular ejection fraction,FAR and NPAR of the two groups had statistical significance(all P<0.05).There was no significant difference in erythrocyte count,large platelet ratio,total cholesterol,low density lipoprotein,triglyceride and erythrocyte volume distribution width CV between the two groups(all P>0.05);3.Multivariate logistic regression analysis showed that age,heart rate,leukocyte,aspartate aminotransferase,left ventricular ejection fraction,FAR and NPAR were the independent influencing factors of NSTEMI(P<0.05);4.The ROC curve showed that the area under the curve(AUC)of FAR diagnosis of NSTEMI was 0.722[95%CI(0.653,0.790)],the maximum cut-off value was 0.345,the sensitivity was 0.552 and the specificity was 0.793;The area under curve(AUC)of NPAR in the diagnosis of NSTEMI was 0.909[95%CI(0.869,0.95)],the maximum cut-off value was 0.730,the sensitivity was 0.864 and the specificity was 0.890;5.Pearson correlation analysis showed that FAR and NPAR were positively correlated with Gensini score of NSTEMI patients.Conclusion:1.FAR and NPAR are independent influencing factors of NSTEMI;2.FAR and NPAR may have certain value in the auxiliary diagnosis of NSTEMI;3.FAR and NPAR were positively correlated with the degree of coronary artery stenosis in NSTEMI patients;4.The results of this study may be more valuable to judge the degree of coronary stenosis of NSTEMI patients in primary medical units who underwent unconditional coronary angiography or referral.