The Value Of MPV,PDW,RDW In Predicting Coronary Heart Disease And Severity Of Coronary Artery Lesions

Background and ObjectiveCoronary heart disease(CHD)is a common and frequently-occurring disease in our society.It is also one of the diseases with the highest mortality rate in the world.With the aging of Chinese population,the normalization of quick-paced work and life and the usual ways of life are changed.Not only the traditional risk factors of cardiovascular disease in our life are increasing,but also more new risk factors are adding.Therefore,in China,the morbidity and mortality rate of cardiovascular disease patients is increasing year by year,and showed trend of rapidly growth in younger,low-income groups.The long-term living quality of patients would be seriously affect.Seeking simple,inexpensive,and appropriate clinical observation indices is significant for prevention of coronary heart disease,assessment of severity of coronary artery lesions,clinical treatment and prognosis.The purpose of my study is to determine the relationship between the level of three indices,mean platelet volume(MPV),platelet distribution width(PDW)and red blood cell distribution width(RDW),which are common but usually be overlooked in blood routine examination,and prediction of coronary heart disease,assessment of severity of coronary artery lesions and prognosis.It would provide some evidence for clinical decisions.MethodsFrom December 2017 to June 2018,250 patients who were hospitalized in the department of cardiovascular of the second affiliated hospital of Zhengzhou university and underwent coronary angiography,and whose clinical data were complete after the inclusion and exclusion criteria in the later stage were selected.The general data,biochemical index,MPV,PDW,RDW and the result of coronary angiography were collected.According to the coronary angiography,the patients were divided into coronary heart disease group(196 cases)and control group(54 cases),computing patients' Gensini score and SYNTAX score of coronary heart disease group.According to the SYNTAX score of patients,they were divided into mild group,moderate group and severe group.Using SPSS24.0 software for statistical analysis,comparing the general data,biochemical indexes differences between coronary heart disease group and control group.The correlation between the level of MPV,PDW,RDW and the Gensini score,SYNTAX score was analyzed.The level of MPV,PDW,RDW differences between three groups of SYNTAX score were compared.Logistic regression was used to analyze the relationship between coronary heart disease and various factors.Using ROC curve to analyze the sensitivity,specificity and cut-off value of MPV,PDW and RDW for predicting coronary heart disease.The difference was statistically significant at P<0.05.Results(1)There was no significance statistical difference in smoking,TC,TG between coronary heart disease group and control group(P>0.05).However,compared with control group,patients in coronary heart disease group were older,had a higher proportion of men,had more hypertension and diabetes,besides,the level of BMI,LDL-C,UA,Cr,MPV,PDW,RDW was higher than the control group,and HDL-C of control group was higher than the coronary heart disease group.The differences of the results were statistically significant in two groups(P<0.05 or P<0.01).(2)Compared between three SYNTAX groups,the level of MPV,PDW,RDW was higher than the lower SYNTAX group(P<0.05 or P<0.01).(3)There was a positive correlation between MPV(r=0.206,P<0.01;r=0.277,P<0.01),PDW(r=0.144,P<0.05;r=0.150,P<0.05),RDW(r=0.230,P<0.01;r=0.227,P<0.01)and Gensini scores,SYNTAX scores in CHD group.(4)The CHD as the dependent variable,the univariate logistic regression analysis revealed that age,LDL-C,MPV,PDW,RDW and Cr was the independent predictor of CHD,while HDL-C was the independent protective factor of CHD.(5)ROC analysis indicate that the cut-off points of MPV,PDW and RDW for predicting CHD were 11.38fl(sensitivity 57.7%,specificity 83.3%,AUC 0.670),12.85fl(sensitivity 68.5%,specificity 47.9%,AUC 0.806)and 12.42%(sensitivity 59.3%,specificity 30.7%,AUC 0.786) respectively.Conclusions(1)Increased the level of MPV,PDW and RDW is an independent correlative factor of coronary heart disease.(2)Increased the level of MPV,PDW,and RDW is associated with severity of coronary artery disease.