The Correlation Between The Deceleration Capacity Of Rate And The Severity Of Coronary Artery Lesions And Its Prediction Value On Sudden Cardiac Death In Patients With Acute Coronary Syndrome

Objective To investigate the correlation between the deceleration capacity of rate(DC)and the severity of coronary artery lesions and its prediction value on sudden cardiac death(SCD)in patients with acute coronary syndrome.Methods 142 patients with ACS and 52 patients without coronary artery disease as control group who underwent coronary angiography(CAG)were selected in the department of cardiology at the Third Affiliated Hospital of Anhui Medical University from August 2016 to May 2017.The ACS was divided into ST-segment elevation myocardial infarction(STEMI)group and non-ST elevation acute coronary syndrome(NSTE-ACS)group.We compared DC value and the difference of heart rate variability(HRV)in ACS group and control group.The scope and severity of coronary artery lesions in ACS patients were evaluated by the number of coronary artery lesions and Gensini score,then we analyzed its relationship with DC level.Meanwhile,the follow-up of ACS patients(8.7±1.8 months)was observed,and the sudden cardiac death(SCD)occurred during the follow-up period was observed.Results(1)Compared with the control group,we found no significant difference in age,gender,smoking,hypertension and diabetes mellitus in ACS group.While the difference of total cholesterol,low density lipoprotein cholesterol and uric acid between the two groups were statistically significant.(2)The DC value and HRV parameters(SDNN,rMSSD,pNN50)of the ACS group were all lower than that of control group(P <0.05).(3)DC value was positively correlated with SDNN(r=0.62)?rMSSD(r=0.427)and pNN50(r=0.238)in patients with ACS.(4)The DC value of the STEMI group was lower than that of the NSTE-ACS group,while the Gensini score was higher than that of the NSTE-ACS group and both were significantly different(P <0.05).(5)The DC value of the multi-vessle disease group was lower than that of the double-vessle disease groups and the single-vessle disease group(P <0.05),and double-vessle disease groups was lower than that of the single-vessle disease group(P <0.05).(6)DC was negatively correlated with Gensini score(r=-0.407,P<0.01)in patients with ACS.(7)The DC value of the SCD group was lower than that of the non-SCD group [(2.43±0.78)?(5.61±1.47),t=-1.942,P<0.01]during the follow-up period in ACS patients Conclusion(1)DC value decreased markedly and it was closely associated with the severity and scope of coronary artery lesions in ACS patients.(2)DC has certain clinical reference value in the screening and early warning of sudden cardiac death.