Correlation Between Pan-Immune Inflammatory Values,Premature Coronary Artery Disease And The Severity Of Coronary Artery

Background:Coronary atherosclerotic heart disease(CAD)is a type of chronically inflammatory disease that is a common cause of disability and death in our country.With the change of people’s diet structure and lifestyle,CAD patients are getting more and more young,causing a huge economic burden to the country and families.Premature coronary artery disease is usually(PCAD)defined as CAD patients with an age of onset <55 years in a male and <65 years in a female.Recently,biomarkers based on blood cell parameters such as systemic immune-inflammation index(SII)and systemic inflammation response index(SIRI)have been widely used to investigate cardiovascular diseases,and studies have confirmed that SII and SIRI are associated with coronary artery disease and are predictive of the severity of coronary artery lesions.The Pan-Immune-Inflammation Value(PIV)is a new inflammatory index that was derived based on blood cell parameters,and its relationship with PCAD and the degree of coronary artery disease is unclear.Objective:This study focused on the relationship between PIV and PCAD and the severity of its coronary lesions,as well as the ability of PIV to predict the severity of coronary lesions.This study included 260 patients with PCAD diagnosed by coronary angiography as the study group,100 patients with CAD were excluded as the control group from January 2021 to May 2022 for chest pain at Subei People’s Hospital.General data and laboratory tests were collected from the included subjects,and the American Heart Association Gensini score was used to evaluate the severity of coronary lesions in patients of the PCAD group.According to the severity of coronary lesions,PCAD patients were divided into mild coronary disease group(Gensini score <30)and severe coronary disease group(Gensini score ≥30).The t-test,chi-square test,and Mann-Whitney U test were used to compare the differences in general information and laboratory findings between the PCAD and control groups,and between the mild coronary disease and severe coronary disease groups.Spearman analysis was used to analyze the correlation between PIV and Gensini score.The relationship of PIV with PCAD and coronary disease severity was analyzed using logistic regression.The best cut-off value,the AUC,Jorden index,sensitivity,and specificity of PIV for predicting severe coronary artery disease were measured by plotting the subjects’ operational characteristic curves and compared with SII and SIRI for predicting severe coronary artery disease using Z test.p < 0.05 difference was statistically significant.Results:1.The age and high density lipoprotein cholesterol of patients in the PCAD group were lower than those in the control group,and the differences were statistically significant(P < 0.05);the proportion of men,the proportion of smoking and drinking history,uric acid,fasting glucose,neutrophils,monocytes,platelets and PIV(223.13(127.91,495.69)vs 129.18(94.47,207.05))of patients in the PCAD group were higher than those in the control group,and the differences were statistically significant(P < 0.05).2.The age and high density lipoprotein cholesterol(HDL-C)of patients in the severe disease group were lower than those in the mild disease group,and the difference was statistically significant(P < 0.05);the proportion of men,the proportion of smoking history,uric acid,triglycerides,hemoglobin,monocytes,platelets,SII,SIRI,and PIV(380.78(225.18,713.84)vs 148.42(91.99,222.18))of patients in the severe disease group were higher than those in the mild disease group,and the difference was statistically significant(P < 0.05).3.Spearman correlation analysis showed a positive relationship between PIV and Gensini score.(r=0.559,p<0.001).4.Multifactorial Logistic regression analysis showed that HDL-C(OR=0.410,95%CI: 0.174 to 0.964,P=0.041)was independent protective factor for PCAD.And,Smoking(OR=2.388,95% CI: 1.169 to 4.877,P=0.017),fasting glucose(OR=1.228,95% CI:1.025 to 1.472,P=0.026),and PIV(OR=1.004,95% CI: 1.002 to 1.006,P<0.001)were independent risk factors.5.Multifactorial Logistic regression analysis showed that smoking(OR=2.2555,95%CI: 1.096 to 4.640,P=0.027)and PIV(OR=1.002,95% CI: 1.001 to 1.003,P<0.001)were independent risk factors for the severe coronary lesions in PCAD.6.The AUC of PIV was 0.776(best cut-off value=211.28,sensitivity 76%,specificity 74%)and the AUC of SII and SIRI were 0.702 and 0.773,respectively.There was no significant difference between PIV and SIRI in predicting severe coronary artery lesions in patients with PCAD.PIV had better ability to predict the severe coronary lesions in patients with PCAD compared with SII(P < 0.05).Conclusion:PIV is an independent risk factor for PCAD and the severity of coronary artery lesions.PIV was positively correlated with Gensini score.As PIV increasing,the degree of coronary artery disease became more severe.PIV is a better novel hematological index that can be used to predict the severity of PCAD.When the PIV value is ≥211.28,severe coronary artery disease is more likely to occur,and its predictive ability is similar to SIRI,but better than SII.