Study On The Correlation Between Risk Stratification And MPV And FIB In Patients With NSTEMI Fever-induced Wind Syndrome

BackgroundAcute non-ST-segment elevation myocardial infarction(NSTEMI)which come on quickly has become one of the most serious diseases.Professor Xian Wang thinks that acute coronary syndrome come on rapidly and ACS is variable,which is similar to the wind syndrome in the field of traditional Chinese medicine.So Professor Xian Wang puts forward the theory of "endogenous collateral wind".Our team's previous researchs discover that the moment of onset of NSTEMI shows heat-toxin engendering endogenous collateral wind syndrome usually.Due to sputum,stasis and turbid dampness putrescence together,with the combination of dampness pathogen and heat-toxin,the heat-toxin engendering endogenous collateral wind syndrome is formed,which threatens patients' life.Therefore,early risk stratification is of great significance to identify high-risk patients and save lives.Global Acute Coronary Events Registered risk score(Global Registry Of Acute Coronary Events,GRACE)is considered to be one of the most effective tools which can predict the risk of NSTEMI and provide clinical treatment strategies,and it can identify high-risk patients quickly and accurately.The primary pathological basis of NSTEMI is the formation of white thrombus,and white thrombus is formed by platelet and fibrinogen.Many studies have found that the mean platelet volume(MPV)is an important factor in thrombosis and Fibrinogen(FIB)is a kind of clotting factor or inflammatory markers.MPV and FIB have formed a close relationship with the development of NSTEMI.Therefore,in order to evaluate the value of risk stratification of NSTEMI patients with heat-toxin engendering endogenous collateral wind syndrome,MPV and FIB are included in this study.ObjectiveIn this study,under the guidance of the theory of "endogenous collateral wind",risk stratification was conducted for NSTEMI patients with heat-toxin engendering endogenous collateral wind syndrome according to use GRACE scoring method.The ratio distribution in the non-high-risk groups and high risk groups of the number of NSTEMI patients with heat-toxin engendering endogenous collateral wind syndrome will be explored.The correlation between MPV and FIB and GRACE scores will be analyzed.The differences between MPV and FIB in patients with different groups will be explored.We want to determine whether MPV and FIB are risk factors for NSTEMI patients.The ROC curve will be used to find the best cut-off point value and to analyze the predictive value of MPV and FIB for high-risk patients with heat-toxin engendering endogenous collateral wind syndrome.Methods1 Medical record collection table was designed to collect NSTEMI patients with heat-toxin engendering endogenous collateral wind syndrome.2 Risk stratification:using GRACE scoring method and using GRACE scoring 2.0 calculator to calculate the score.The patients with GRACE scoring<140 points were classified as non-high-risk group,and>140 points were classified as high risk group.3 General clinical data of the patients were collected,including gender,age,history of hypertension,history of type 2 diabetes,history of cerebral infarction,history of hyperlipidemia,history of drinking and smoking.4 Collecting blood routine and coagulation related parameters:MPV and FIB.5 Statistical analysis.Results1 Seventy-two NSTEMI patients with heat-toxin engendering endogenous collateral wind syndrome were collected,including 47%(34 cases)in the non-high-risk group,and 53%(38 cases)in the high-risk group.2 There was no significant difference in gender distribution,history of hypertension,history of type 2 diabetes,history of cerebral infarction,history of hyperlipidemia,history of drinking and smoking between the two groups(P>0.05).MPV,FIB and age were statistically significant between the two groups(P<0.05),and MPV,FIB and age were significantly increased in the high-risk group.3 MPV(P<0.05,B=9.807),FIB(P<0.05,B=17.291)and age(P<0.05,B=1.528)were independent risk factors for GRACE scoring.4 Both MPV(P<0.05,OR=3.69,95%CI:1.205-11.296)and FIB(P<0.05,OR=10.389,95%CI:2.422-44.557)were predictors of GRACE score in high-risk patients.5 Medcalc software was used to analyze the predictive value of MPV and FIB values on high-risk Grace scores by using ROC curve statistical method.? The predictive value of MPV for high-risk Grace scores:the area under the curve was 0.806(95%CI:0.696-0.890,P<0.05).When the optimal cut-off point value was 9.19fL,the specificity and sensitivity of MPV to predict high-risk Grace score were 76.47%and 78.95%respectively.? The predictive value of FIB for high-risk Grace scores:the area under the curve was 0.879(95%confidence interval was 0.781-0.944,P<0.05).When the optimal cut-off point value was 3.38g/L,the specificity and sensitivity of FIB to predict high risk Grace score were 94.12%and 76.32%respectively.? Compared with the predicted values of MPV and FIB for high-risk Grace scores,P=0.187(P>0.05),the difference was not statistically significant.ConclusionThe small sample study found in this paper:1 The high-risk GRACE scoring group accounts for the largest proportion of the NSTEMI patients with heat-toxin engendering endogenous collateral wind syndrome.2 There are significant differences in MPV,FIB and age between the two groups,and the MP V,FIB and age of the high-risk group are higher than those of the non-high-risk group.3 MPV,FIB and Grace scores may be positively correlated.4 MPV and FIB may be independent risk factors for GRACE scoring.5 Both MPV and FIB may have certain predictive value for high-risk GRACE scoring,and there is no difference between MPV and FIB in the predictive value for high-risk GRACE scoring.A multicenter,large sample prospective study will be conducted to draw definitive conclusions.