Correlations Between BaPWV, ABI, FMD And TCM Syndromes In Different Age Groups And Coronary Artery Disease

Objective:To compare ankle-brachial index(ABI),brachial-ankle pulse wave velocity(baPWV)mediated,flow-mediated dilation(FMD),TCM syndrome and the relationship between the degree of stenosis of coronary artery in different age class,the scope of application in different age groups when using ABI?baPWV?FMD for early atherosclerosis noninvasive detection and prediction of diagnosis of coronary heart disease(CHD),improve the accuracy and specificity of three clinical application,choose a more reasonable way of testing.Methods:From September 2018 to April 2019,in Department of cardiology of integrated traditional Chinese and western medicine in china-japan friendship hospital,collecting patients with coronary arteriographyand have clinical manifestations of chest tightness,heart palpitations,angina pectoris,etc.60 hospitalized patients included in this study,average age(61.89+10.77),the male 60 cases(58.8%),42 cases(41.2%)women.Risk factors for general atherosclerosis were collected,ankle-brachial index,brachial-brachial pulse wave conduction velocity,brachial arterial blood flow-mediated vasodilation were measured before angiography,and coronary angiography results were collected.According to the age,it was divided into the elderly group(65 years old)and the middle-aged group(<65 years old).According to the angiographic results,the patients were divided into coronary artery disease group(at least one coronary artery stenosis 50%)and non-coronary artery disease group(coronary artery stenosis<50%),and were divided into stent group and non-stent group according to whether the stent was implanted or not.Results:1.Overall research data,the CHD group and non CHD group general clinical data,related risk factors of atherosclerosis,namely,gender,smoking history,family history of early onset coronary artery disease,BMI,hypertension,blood pressure on admission,history of hyperlipidemia,LDL-C,CHO and TG,history of diabetes,fasting glucose,GA,HblAc,CR,eGFR,Urea,UA,Hcy,clinical data such as HGB no statistical difference.BaPWV,FMD and ABI were statistically significant in the CHD group and non-chd group.ABI area under the curve is 0.687(P<0.05)cut point of 1.115,the sensitivity of 50%,specificity of 75%,the area under the curve of FMD was 0.698(P<0.05)cut point of 6.55,the sensitivity was 79.4%,specificity of 50%,the area under the curve of baPWV was 0.621(P<0.05)cut point for 1836cm/s,the sensitivity of 41.5%,specificity of 85.3%.The area under the ROC curve was 0.800,the sensitivity was 63.2%,and the specificity was 82.4%,indicating that FMD,baPWV and ABI were of general value in the prediction and diagnosis of CHD.3.Among the coronary heart disease patients in the general study population,baPWV,ABI and FMD were compared between the stent group and the non-stent group,and the data of the three groups showed no statistical difference between the two groups,suggesting that baPWV,ABI and FMD could not provide clinical value for patients with coronary heart disease whether they need stent implantation or not.4.Middle age group,CHD group and non CHD group general clinical data no statistical difference,baPWV in CHD group and non CHD group have no obvious differences between ABI and FMD there were significant differences between the two groups,FMD in the area under the ROC curve is 0.688,P<0.05,8.3 as the cutting point,the sensitivity was 55.6%,specificity of 77.1%;ABI area is 0.700,P<0.05,with 1 as the cutting point,the sensitivity of 100%,specificity of 25.7%,the joint use of the three prediction of coronary heart disease,the area under the ROC curve is 0.798,the sensitivity was 62.9%,specificity of 88.9%,displayed in the middle-aged,FMD and ABI value to the diagnosis of coronary heart disease is higher,after the joint use of FMD and ABI,sensitivity and specificity were improved.5.Elderly group,CHD group and non CHD group general clinical data no statistical difference,baPWV,FMD,ABI there were significant differences between the two groups,ABI in the area under the ROC curve is 0.726,1.18 as the cutting point,the sensitivity was 37.5%,specificity of 97%,FMD area is 0.714,6.25 as the cutting point,the sensitivity was 93.8%,specificity of 51.5%,baPWV area under the curve is 0.704,with 1987 cm/s as the cutting point,sensitivity of 48.4%,specificity of 93.7%,The area under the ROC curve was 0.797,the sensitivity was 54.5%,and the specificity was 93.7%when the three factors were combined to predict cad.6.Overall group,coronary heart disease and coronary heart disease group there are differences between the frequency distribution of TCM syndrome elements,coronary heart disease group with blood stasis and phlegm turbidity as the main elements of syndromes,the group of coronary heart disease(CHD)with qi deficiency and blood stasis,as the main syndrome elements,a line than chi-square test to two groups of data,see chi-square=5.213,P=0.517>0.05,namely cannot think for clinical symptoms such as chest tightness,chest pain clinic of hospitalized patients,coronary stenosis or greater in 50%of patients with coronary artery stenosis<50%of the patients with TCM syndrome elements exist differences between the two groups.7.In patients with coronary heart disease(CHD),in the elderly patients with coronary heart disease with blood stasis,Yin deficiency as the main syndrome elements,middle-aged patients with coronary heart disease with blood stasis and phlegm turbidity as the main elements of syndromes,to two groups of data line than chi-square see chi-square=6.733,P=0.346>0.05,namely in of hospitalized patients symptoms such as chest tightness,chest pain,has not yet found the middle-aged and senile coronary heart disease(CHD)in patients with coronary heart disease patients with the difference between TCM syndrome elements.Conclusion:1.The study population is due to the clinical symptoms such as chest tightness,chest pain clinic of hospitalized patients,found that baPWV in the elderly population is the value of prediction and diagnosis of coronary heart disease,ABI and FMD in all age groups to be used to predict coronary heart disease(CHD)and diagnostic value of points after age class,FMD,baPWV,ABI in predicting coronary heart disease(CHD),with different cutting point,the sensitivity and specificity,the joint use of FMD,baPWV,ABI can improve the value of the three prediction of coronary heart disease.2.In this study,baPWV,ABI and FMD were not found to be of no reference value in whether or not stent implantation was required in the coronary heart disease group.3.In the group of patients with chest pain and chest pain and other clinical treatment due to chest tightness,there was no difference in TCM syndrome elements between patients with coronary artery stenosis 50%and those with coronary artery stenosis<50%.In this population,namely the patients with chest arthralgia and heartache that have recently had attacks,no difference in TCM syndrome elements between elderly patients with coronary heart disease and middle-aged patients with coronary heart disease was found,and blood stasis was the main syndrome element in both groups.