| ObjectivesDiscuss the combination of triglyceride glucose product index(Ty G index)γ-The relationship between glutamyltransferase(GGT)and the severity and prognosis of coronary artery disease in patients with young acute coronary syndrome(ACS).MethodsFrom May 2019 to October 2021,we selected 319 patients who were diagnosed as ACS by coronary angiography(CAG)after receiving medical treatment at the Cardiovascular Department Outpatient or Emergency Department of Huanggu Hospital,the Second Affiliated Hospital of Shenyang Medical College,and described them as discomfort in the precordium.Collect the past medical history,basic clinical features,biochemical indicators,coronary angiography,and other data of all enrolled patients.Observe whether the patient has experienced major adverse cardiovascular events(MACE)during the one-year follow-up period,and divide the patient into a MACE group(n=56)and a non MACE group(n=263).According to the Gensini score of the severity of coronary artery injury,all ACS patients were divided into a mild coronary stenosis group of 215 cases(Gensini score<20 points),a moderate coronary stenosis group of 80 cases(Gensini score 20-40 points),and a severe coronary stenosis group of24 cases(Gensini score>40 points).All ACS patients were divided into single vessel lesion group(n=164),double vessel lesion group(n=64),and triple vessel lesion group(n=91)based on the number of different lesion branches of the coronary artery.Use SPSS29.0 statistical software for data analysis.The measurement data conforming to normal distribution are expressed in the form of mean ± standard deviation,and the comparison between the two groups adopts two independent sample t-test;The measurement data that do not conform to the normal distribution are expressed by the median(quartile interval).The Mann Whitney test(U test)is used for the comparison between two groups,Kruskal Wallis test(H test)is used for the comparison between multiple groups,and Bonferroni test is used for the comparison between two groups;The counting data is represented by rate,and the comparison between groups is conducted using chi square test;Using a binary logistic risk regression model,analyze the independent risk factors that affect the occurrence of MACE events;Further draw the receiver operating characteristic curve(ROC curve)of the subject,and evaluate the predictive value of Ty G index,GGT,and their combination for MACE events by calculating the area under the curve(AUC).All testing methods use a bilateral test,with the testing level set to P≤0.05.Results1.There was no statistical difference in age,hypertension history,diabetes history,smoking history,drinking history,BMI and other aspects of general information between the MACE group and the non MACE group(P>0.05),but there was statistical difference in gender(P<0.05).2.In terms of laboratory examination,the Ty G index,GGT,SCr,UA,AST,ALT,and TG of the mace group were higher than those of the non mace group,while the HDL-C of the mace group was lower than that of the non mace group,with a statistically significant difference(P<0.05).There was no statistically significant difference in FPG,TC,LDL-C,and BUN between the two groups(P>0.05).3.Binary logistic regression analysis showed that GGT(OR=1.031,95% CI:1.020~1.043,P<0.001),Ty G index(OR=2.066,95% CI: 1.058~4.033,P=0.033),and SCR(OR=1.043,95% CI: 1.015~1.072,P=0.002)were independent predictors of MACE events in ACS patients.4.The ROC curve results showed that the area under the curve(AUC)of Ty G index,GGT,and their combination in predicting MACE events in young ACS patients were 0.709(95% CI: 0.629~0.788,P<0.001),0.773(95% CI: 0.698~0.849,P<0.001),and 0.832(95% CI: 0.765~0.900,P<0.001),respectively.When the Ty G index takes the optimal cutoff value of 9.175,the maximum Jordan index is 0.387,and the sensitivity and specificity are 0.714 and 0.673,respectively.When the optimal cutoff value of GGT is 101.85U/L,the maximum Jordan index is 0.5,and the sensitivity and specificity are 0.500 and 1,respectively.When the optimal cutoff value of 0.207 is chosen for the combination of the two,the maximum Jordan index is 0.561,and the sensitivity and specificity are 0.679 and 0.882,respectively.5.The pairwise comparison of GGT and Ty G indices between subgroups with different degrees of coronary artery injury showed that there were statistically significant differences in GGT and Ty G indices between the mild and moderate coronary artery stenosis groups(P<0.05).The difference in GGT between the mild and severe coronary artery stenosis groups was statistically significant(P<0.05),while there was no statistically significant difference between the moderate and severe coronary artery stenosis groups(P>0.05);There was no statistically significant difference in the Ty G index between the mild and severe coronary stenosis groups,as well as the moderate and severe coronary stenosis groups(P>0.05).6.The pairwise comparison of GGT and Ty G indices between different subgroups of coronary artery disease showed that there were statistically significant differences in GGT and Ty G indices between the single vessel disease group and the double vessel disease group,as well as between the single vessel disease group and the three vessel disease group(P<0.05),while there was no statistically significant difference between the double vessel disease group and the three vessel disease group(P>0.05).Conclusions1.The higher the level of triglyceride glucose product index,the more branches of coronary artery lesions.2.The higher the glutamyltransferase level,the greater the degree of coronary stenosis and the number of lesion branches.3.The higher the triglyceride glucose product index and glutamyltransferase levels,the higher the probability of Mace events occurring within one year in young ACS patients.4.The combination of triglyceride glucose product index and glutamyltransferase can effectively predict the adverse prognosis of young ACS patients,and has significant implications for the diagnosis,treatment,and evaluation of adverse prognosis in future ACS patients. |
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