Correlation Between Platelet Distribution Width/Platelet Count And The Severity Of Coronary Artery Disease In Patients With Coronary Heart Disease

Objective:The relationship between the platelet distribution width(PDW)/ platelet count(PC)and the severity of coronary artery disease in patients with coronary heart disease(CHD)was explored to provide a certain reference value for evaluating the severity of disease in patients with CHD.Method : A total of 289 patients who were admitted to the Department of Cardiovascular Diseases of Dongguan Branch of Yan'an University Affiliated Hospital from September 2018 to September 2019 and diagnosed with coronary heart disease(CHD)by coronary angiography(CAG)were selected as the research subjects.According to the clinical type of CHD,patients were divided into 3 groups: 98 patients with stable angina pectoris(SA group),96 patients with non-ST-elevation acute coronary syndrome(NSTE-ACS group),and 95 patients with ST-elevation acute coronary syndrome(STE-ACS group);according to the SYNTAX score,all patients were divided into 103 low-risk groups(SYNTAX score <23 points),99 intermediate-risk groups(23points ? SYNTAX score <33 points),and 87 high-risk groups(33 points ? SYNTAX score).Record the gender,age,and previous medical history(history of smoking,hypertension,and diabetes)of all subjects;measure height,weight,and calculate body mass index(BMI).Collection of clinical indicators such as routine blood test,liver function,renal function,blood lipids,glycated hemoglobin(HbA1c)and other clinical indicators;blood platelet distribution width(PDW)and platelet count(PC),and mean platelet volume(MPV)and white blood cells(WBC),calculate the PDW / PC ratio,MPV / PC ratio;calculate the estimated glomerular filtration rate(eGFR)according to the CKD-EPI formula,improve the heart color Doppler ultrasound,and collect the left ventricular ejection fraction(LVEF).All study subjects underwent emergency or elective CAG.Stent implantation was performed on patients with indications,and the SYNTAXscore was calculated using the SYNTAX official website.Analyze the following:differences between baseline and clinical data of SA group,NSTE-ACS group and STE-ACS group;differences of research indicators between the three groups of SYNTAX score groups;correlation between PDW/PC,MPV/PC,PDW,MPV,PC and SYNTAX scores in CHD patients;evaluation by ROC curve:the predictive value of PDW/PC on high-risk SYNTAX scores in patients with CHD;and the use of ordered logistic regression analysis to assess the risk factors affecting the severity of CHD.Results:1.There were no differences in SA,NSTE-ACS and STE-ACS groups in terms of gender,smoking history,history of hypertension,history of DM,age,BMI,WBC,eGFR,and LVEF(P> 0.05).Compared with SA group,HbA1 c and TC in STE-ACS group increased(P <0.05).The PDW / PC,MPV / PC,SYNTAX score,PDW,MPV and LDL-C were higher than NSTE-ACS group and SA group(P <0.05),PC was lower than NSTE-ACS group and SA group(P <0.05);in NSTE-ACS group,PDW / PC,MPV / PC,SYNTAX score,PDW,MPV and LDL-C were higher than SA group(P<0.05),and PC was lower than SA group(P <0.05).2.There were no differences in age,BMI,WBC,HbA1 c,eGFR and LVEF among the three SYNTAX score groups(P> 0.05).TC and LDL-C in the high-risk group were higher than those in the first two groups(P <0.05);compared with the middle group,the LDL-C in the low-risk group was reduced(P <0.05);PDW / PC,MPV / PC,PDW,and MPV in the high-risk group were higher than those in the intermediate-risk and low-risk groups(P <0.05),and the PC was low In the intermediate-risk group and the low-risk group(P <0.05);compared with the low-risk group,PDW / PC,MPV / PC,PDW,and MPV increased in the intermediate-risk group(P <0.05),and PC decreased(P <0.05).3.Correlation analysis showed that PDW / PC of patients with CHD was positively correlated with SYNTAX score(r = 0.575,P = 0.000);MPV / PC,PDW,and MPV were also positively correlated with SYNTAX score(r were 0.558,0.519,0.473,P = 0.000);PC and SYNTAX score were negatively correlated(r =-0.480,P = 0.000).4.ROC curve analysis: The AUC predicted by PDW / PC for high-risk SYNTAX score was 0.753(95% CI: 0.694-0.812,P = 0.000).When the PDW / PC cut value wasspecificity was 51.5 %.5.Ordered Logistic Regression: The SYNTAX score group includes three groups:low-risk,intermediate-risk,and high-risk.The score increases,indicating that the severity of the disease has increased.It is used as the dependent variable and each research indicator is used as the independent variable.The use of ordered Logistic regression analysis shows that Diabetes,PDW,PC,HbA1 c,TC,and LDL-C were all risk factors affecting the severity of CHD(P <0.05).Conclusions:PDW and PC are simple and readily available clinical indicators,and their ratio is positively correlated with the SYNTAX score of patients with CHD.It can be used for early assessment of the severity of coronary artery disease and guidance of clinical diagnosis and treatment,early intervention for patients,and improved prognosis.When PDW / PC> 0.05571,it indicates that CHD patients may have higher SYNTAX score.Diabetes,PDW,PC,HbA1 c,TC and LDL-C are risk factors that affect the severity of CHD.