| Objective:To investigate the correlation between the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP)and fibrinogen(Fib)and the severity of coronary artery disease in patients with coronary heart disease(CHD)and the predictive value of NT-proBNP and Fib levels for the severity of coronary artery disease.Methods:A total of 306 consecutive inpatients in the Department of Cardiology of Inner Mongolia Forestry General Hospital from December 1,2020 to April 30,2022 were included.238 patients with coronary heart disease diagnosed by coronary angiography(CAG)were set as the coronary heart disease group,and 68 patients with negative coronary angiography results were set as the non-coronary heart disease group.According to the coronary angiography results of each patient,according to Gensini score(GS),which can reflect the severity of coronary artery disease,the patients with coronary heart disease were divided into low GS group(Gensini<20);There were 118 subjects in the high GS group(Gensini ≥ 20).The basic data,laboratory indicators and results of coronary angiography of 306 patients were recorded in detail,as well as the quantitative results of Gensini score of each patient.The correlation of NT-proBNP and Fib levels with the severity of coronary artery disease in patients with coronary heart disease was analyzed.Results:(1)The clinical general data and laboratory indexes were compared between the non-CHD group and the CHD group.The proportion of patients with hypertension and diabetes was higher in CHD group,and the difference was statistically significant(P<0.05);The age,TC,hs-c Tn T,FBG,NT-Pro BNP and Fib levels of the CHD group were higher than those of the non-CHD group,and the results were statistically significant(P<0.05).(2)Logistic regression analysis of CHD related factors,after adjusting other factors,age,history of diabetes,NT-Pro BNP were independently associated with the onset of CHD,the results were statistically significant(P<0.05).(3)The clinical general data and laboratory indexes of the low GS group and the high GS group were compared.The proportion of patients with diabetes was higher in high GS group,and the difference was statistically significant(P<0.05);The levels of hs-c Tn T,FBG,TC,LDL-C,NT-Pro BNP and Fib in the high GS group were higher than those in the low GS group,and the results were statistically significant(P<0.05).(4)Spearman analysis was used to analyze the correlation between each variable and Gensini score.Results: NT-proBNP(r=0.681,P<0.001),Fib(r=0.500,P<0.001),History of diabetes(r=0.196,P=0.001),hs-c Tn T(r=0.368,P<0.001),FBG(r=0.206,P=0.001)were positively correlated with Gensini score,with statistical significance(P<0.05).(5)Multivariate Logistic regression analysis of the severity of coronary artery disease showed that FBG,Fib and NT-proBNP were independently related to the severity of coronary artery disease after adjusting other factors.The results were statistically significant(P<0.05).(6)ROC curve was used to evaluate the diagnostic value of NT-proBNP and Fib levels for high GS group,the sensitivity of NT-proBNP to predict the high GS group was 70.30%,the specificity was 90.80%,and the AUC was 0.857(95% CI: 0.809-0.835),the optimal cut-off value was 145.05pg/m L,P<0.05;The sensitivity of Fib to predict the high GS group was 59.30%,the specificity was 81.70%,the AUC was 0.777(95% CI: 0.719-0.835),and the best cut-off value was 3.415g/L,P<0.001;The sensitivity and specificity of the combination of NT-proBNP and Fib for predicting the high GS group were 82.20% and 80.00%,respectively.The AUC was0.891(95% CI: 0.851-0.931),P<0.001.Conclusion:(1)NT-proBNP and Fib levels are related factors for the onset of coronary heart disease,and are correlated with the severity of coronary artery disease,which can predict the severity of coronary artery disease in patients with coronary heart disease.(2)NT-proBNP and Fib levels are independent predictors of the severity of coronary artery disease in patients with coronary heart disease.(3)The combination of NT-proBNP and Fib is superior to single index in predicting the severity of coronary artery disease. |
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