| Objective:The research aims to study the distribution of traditional Chinese medicine(TCM)syndrome elements in patients with acute coronary syndromes(ACS)and explore the correlation between the plaque characteristics of coronary-computed tomography angiograph(CCTA),coronary artery calcium score and the risk of ACS,thus can create a simple,non-invasive and practical method to appraise the risk of ACS earlier by combining traditional risk factors and above factors.Methods:150 patients with diagnosis of coronary heart disease(CHD)who had done coronary angiography in ZhuJiang Hospital of Southern Medical University or Hospital of Integrated Traditional and Western Medicine of Southern Medical University from January 2021 to December 2022 were retrospectively included and divided into group of stable angina pectoris(SAP)and group of ACS according to the occurrence of ACS.Observation indices were collected such as the gender,age,body mass index,personal history,family history,past medical history,plaque characteristics of CCTA,the stenosis degree of coronary lumen,coronary artery calcium score(CACS),general biochemical indicators,and diagnostic information of TCM syndrome elements.Statistical methods such as T test,Chi-square test,and variance analysis were used to compare the differences in clinical data among the groups.Binary logistic regression was used to analyze the correlation between each factor and the risk of ACS.Results:(1)Compared with the patients in SAP group,the proportions of male,smoking,overweight and obesity,hypertension and diabetes in the patients of ACS group were significantly increased,the difference was statistically significant(P<0.05);(2)The proportion of patient with non-calcified plaques leading to maximum stenosis of lumen and the total number of non-calcified plaques in ACS group were significantly higher than those in SAP group.The proportion of patient with CACS=1-99 in ACS group was higher than that in SAP group,the difference was statistically significant(P<0.05);(3)The levels of low density lipoprotein cholesterol(LDL-L),fasting plasma glucose and hemoglobin AlC(HbA1c)in ACS group were higher than those in SAP group;The total cholesterol of non-calcified plaque group was higher than that of calcified plaque group.The high density lipoprotein cholesterol of non-calcified plaque group was lower than that of mixed plaque group and calcified plaque group.LDL-L and HbAlc in non-calcified plaque group were higher than those in mixed plaque group and calcified plaque group,and LDL-L in mixed plaque group was higher than that in calcified plaque group,the difference was statistically significant(P<0.05);(4)The proportion of patient with phlegm turbidity syndrome or blood stasis syndrome in ACS group was higher than those in SAP group;The proportion of patient with phlegm turbidity syndrome and blood stasis syndrome in the non-calcified plaque group was higher than the other two groups.The proportion of patient with qi stagnation syndrome in the mixed plaque group was higher than the other two groups,the difference was statistically significant(P<0.05);(5)males(OR=2.843),smoking(OR=2.354),diabetes(OR=2.485),L DL-Llevel(OR=2.717),blood stasis syndrome(OR=1.785),CACS=1-99(OR=2.236),and non-calcified plaque(OR=2.656)are risk factors affecting the happen of ACS.Conclusions:(1)TCM syndrome elements in CHD population have different meaning for the risk of ACS,and blood stasis syndrome is an important syndrome element to evaluating high ACS risk in CHD patients.(2)The distribution of phlegm turbidity syndrome,qi stagnation syndrome and blood stasis syndrome varies in different plaque groups,suggesting that the distribution of TCM syndrome elements was correlated with plaque properties.(3)males,smoking,diabetes,LDL-L level,blood stasis syndrome,CACS=1-99,and non-calcified plaque are risk factors for ACS.This study provides a simple,non-invasive and practical assessment method to evaluate risk of ACS based on the analysis of CCTA plaque characteristics,coronary artery calcium score,TCM syndrome elements and other risk factors. |
PDF Full Text Request