Correlation Between Platelet Parameters Combined With NLR And The Degree Of Coronary Artery Lesions In Patients With Acute Coronary Syndrome

Objective: To analyze the correlation between platelet parameters and neutrophil-to-lymphocyte ratio(NLR)and the degree of coronary artery disease in patients with the acute coronary syndrome(ACS).Methods: A retrospective analysis was performed on 237 patients with ACS who attended the Department of Cardiology and underwent coronary angiography at the Third Affiliated Hospital of Anhui Medical University from l 2021 to March 2022,divided into the unstable angina group(n=122)and the acute myocardial infarction group(n=115);patients who visited the Department of Cardiology for chest pain and had negative coronary angiography results during the same period were selected as the control group(n=88).The Gensini score was used as a criterion to assess the degree of coronary stenosis,and the patients with ACS were divided into low-scoring(n=80),medium-scoring(n=80),and high-scoring groups(n=77)according to the Gensini score.The differences in general data and laboratory parameters between these groups were compared,and Spearman correlation analysis was used to analyze the correlation between PLT,MPV,PDW,and NLR and Gensini score and the number of coronary artery lesion branches;multi-factor logistic regression was used to analyze the risk factors for the development of ACS;ROC curves were plotted to assess the effects of MPV,PDW,NLR,and the combination of the three on The predictive value of MPV,PDW,NLR and the combination of the three on the severity of coronary lesions in ACS patients was assessed by drawing ROC curves.Results:(1)There were no statistically significant differences in age,history of diabetes,history of alcohol consumption,and TG levels among patients in the AMI,UA,and control groups(P>0.05).There were statistically significant differences between the three groups in gender,history of hypertension,smoking history,CHOL,LDL-c,HDL-c,PLT,MPV,PDW,and NLR levels(P<0.05),with the AMI group having a higher percentage of males,smoking history,CHOL,LDL-c,MPV,PDW,and NLR levels than the UA group and the control group;the UA group had higher HDL-c,MPV and PDW levels in the UA group were higher than those in the control group;while the PLT levels in the AMI group were significantly lower than those in the UA group and the control group.(2)MPV,PDW,and NLR levels in the high Gensini score group were significantly higher than those in the medium score group and low score group,and PLT levels were significantly lower than those in the medium score group and low score group,with statistically significant differences(P<0.05);MPV,PDW,and NLR levels in the medium Gensini score group were significantly higher than those in the low Gensini score group,and PLT levels were significantly lower than those in the low Gensini score group,with statistically significant differences(P<0.05).The number of coronary lesions was also statistically different among the three groups(P<0.05).(3)MPV,PDW,and NLR were positively correlated with the Gensini score and number of coronary lesions(P<0.05);PLT was negatively correlated with the Gensini score and number of coronary lesions(P<0.05).(4)Multi-factor logistic regression analysis showed that PDW,NLR,and hypertension could be used as predictors for the occurrence of ACS(OR=5.246,1.450,3.522,P<0.01).(5)Subject work characteristic(ROC)curve analysis showed that the area under the curve predicted by NLR for high Gensini score was 0.767(95% CI:0.703～0.830,P<0.05),the best diagnostic cut-off point was 4.185,the sensitivity was 75.3%,and the specificity was 67.5%;The area under the curve of MPV predicting high Gensini score was 0.781(95% CI: 0.723-0.839,P<0.05),the best diagnostic cutoff point was 10.050,the sensitivity was85.7%,and the specificity was 56.9%;The area under the curve of PDW predicting high Gensini score was 0.781(95% CI: 0.717-0.844,P<0.05),the best diagnostic cutoff point was 16.350,the sensitivity was 57.1%,and the specificity was 86.3%;NLR,MPV and PDW combined to predict the area under the curve of high Gensini score increased to 0.830(95% CI: 0.777 ～0.883,P<0.05),the best diagnostic cut-off point was 0.208,the sensitivity was 88.3%,and the specificity was 61.3%.Conclusion:(1)There is a significant correlation between PLT,MPV,PDW,NLR and Gensini score and the number of coronary artery lesion branches,which can be used as an index to assess the degree of coronary lesions in patients with ACS,and the combined predictive value of MPV,PDW and NLR on the degree of severe coronary lesions is better than that of MPV,PDW and NLR alone.(2)PDW,NLR and hypertension can be used as independent risk factors for the development of ACS and have some predictive value for the development of ACS.