Correlation Between SYNTAX Score Of Coronary Heart Disease And TOAST Classification Of Cerebral Infarction

Research background and purpose:The incidences of cardiovascular and cerebrovascular diseases have a certain correlation.Few studies have studied the relationship between coronary heart disease and the TOAST classification of cerebral infarction.This study was to investigate the correlation of SYNTAX score with cerebral infarction and TOAST subtypes in patients with coronary heart disease,who had completed percutaneous coronary angiography.In order to screen early patients with high risk cerebrovascular disease in coronary angiography patients and provide theoretical basis for preventing cerebral infarction in patients with coronary heart disease.Materials and Methods:From October 2018 to September 2019,532 patients who were admitted to the department of cardiology and geriatrics of the first affiliated hospital of chengdu medical college to be diagnosed with coronary heart disease were selected as the research subjects.The results of percutaneous coronary angiography of all patients were scored by SYNTAX and divided into low-risk group,intermediate-risk group and high-risk group;In addition,the patients were divided into cerebral infarction group and non-cerebral infarction group.According to the classic cerebral infarction classification method(TOAST classification),cerebral infarction was divided into: type 1(aortic atherosclerosis type),type 2(cardiogenic embolism type),type 3(small arterial disease type),Type4(clear cause),type 5(unknown cause).First we compared the baseline data,comorbidities,SYNTAX scores and past medical history between the cerebral infarction group and the non-cerebral infarction group.Then,factors with P<0.2 in univariate analysis were included in multivariate logistic regression analysis to analyze it?s effects on cerebral infarction.Then the SYNTAX points were analyzed by age and gender.Finally,the differences in the prevalence of cerebral infarction(TOAST classification)in different SYNTAX score groups were analyzed.SPSS 21.0 statistical software was used for statistical analysis.Firstly,univariate analysis was performed.Chi-square test was performed on the count data.T-test and analysis of variance were performed on the measurement data.Results:1.Compared with the cerebral infarction group,the age,BMI,diastolic blood pressure,hemoglobin,Hcy,HDLC,CKD,hypertension,hyperlipidemia,diabetes,past stroke history,SYNTAX score and its grouping were statistically significant(P <0.05).Logistic regression analysis results showed that the OR values of age and SYNTAX score were 1.072 and 1.159,respectively,and the risks of cerebral infarction increased by 7.2% for every 1 year increases in age;Each increases in SYNTAX scores increases the risk of cerebral infarction by 15.9%.Age and SYNTAX scores were independent risk factors for cerebral infarction(P <0.001).2.The stratified age showed that the SYNTAX scores of patients with cerebral infarction group was higher than that of non-cerebral infarction group,regardless of whether they were 65 years or older,and with the increase of SYNTAX scores,the proportion of patients with cerebral infarction gradually increased,and the difference was statistically significant.(P<0.001);Gender stratification showed that the SYNTAX score of the cerebral infarction group was higher than that of the non-cerebral infarction group,regardless of male or female,the difference was statistically significant(P<0.001),and as the SYNTAX score increased,the proportion of patients with cerebral infarction gradually increased.The difference was statistically significant(P<0.001).3.Among patients with type 1,2,3,4 & 5 cerebral infarctions,the SYNTAX scores were different between different types of cerebral infarctions,and the difference was statistically significant(P= 0.008);Type 1 cerebral infarction accounted for a larger proportion of high-risk groups with SYNTAX scores,type 2 cerebral infarction was mainly low-risk and high-risk,and type 3 cerebral infarction was the highest proportion of low-risk,the difference was statistically significant(P<0.001).Type 1 cerebral infarction accounted for a larger proportion of the high-risk group with SYNTAX scores,type 2 cerebral infarction was mainly low-risk and high-risk,and type 3 cerebral infarction was the highest proportion with low-risk(P<0.001).4.SYNTAX score was significantly positively correlated with cerebral infarction(r=0.613,P<0.001).The higher the SYNTAX score,the higher the risk of cerebral infarction.The best cutoff point for predicting cerebral infarction with SYNTAX scorewas 11.50 points,the area under the ROC curve was 0.863(95% CI 0.831-0.895,P<0.001),the sensitivity for predicting cerebral infarction was 71.9%,and the specificity was 89.2%.Conclusions:1.The SYNTAX scores of cerebral infarction group is higher than that of non-infarction group.Age and SYNTAX score are independent risk factors for atherosclerotic cerebral infarction.2.Patients with SYNTAX scores in the low-risk group are more likely to have type 3cerebral infarction,patients in the medium-risk group are more likely to have type 1 and type 3 cerebral infarction,and patients in the high-risk group are more likely to have type 1 cerebral infarction;coronary heart disease patients increase with Syntax scores Increased likelihood of cerebral infarction.3.SYNTAX score is positively correlated with cerebral infarction and has a predictive effect on cerebral infarction.