The Study Of Correlation Between TCM Syndrome And RBC Distribution Width,GRACE Score And Prognosis Of Unstable Angina

ObjectiveThrough the collection of clinical cases and the processing of statistical analysis,the distribution characteristics of TCM syndrome types of patients with unstable angina was observed,the correlation between TCM syndrome type of unstable angina and GRACE score,RDW level was explored,the difference accuracy of the prediction of major adverse cardiovascular events within 30 days by using GRACE score,RDW in different syndrome types was contrasted.Method376 emergency patients with coronary heart disease unstable angina were collected and classified according to clinical manifestations.The basic information,heart rate and blood pressure,syndrome type of TCM,CK-MB,cTnT,Cr,WBC,RBC,PLT,RDW,GRACE scores and the MACE within 30 days were recorded.By dividing into different groups according to the risk stratification of GRACE score,the median of RDW level and the occurrence of MACE,the correlation between TCM Syndrome Types,GRACE score,RDW and the occurrence of MACE were analyzed.Results1.In the study,the distribution of TCM syndromes in 376 patients with coronary heart disease unstable angina from high to low was:phlegm stagnation in heart vessel type>heart qi deficiency type>qi stagnation in chest type=heart blood stasis type>yang deficiency of heart and kidney type.2.There was no significant difference in sex,age,history of basic disease or smoking,pulse and blood pressure among the syndromes groups(P>0.05).3.There were differences in cTnT,RBC,RDW,GRACE scores and MACE incidence among the syndrome groups(P<0.05).The cTnT of heart qi deficiency group was higher than that of phlegm stagnation in heart vessel group,the GRACE scores and MACE incidence of heart qi deficiency group was higher than that of phlegm stagnation in heart vessel group and qi stagnation in chest group,the RBC of phlegm stagnation in heart vessel group and qi stagnation in chest group was higher than that of heart qi deficiency group,the RDW of heart and kidney yang deficiency group was higher than that of phlegm stagnation in heart vessel group,which were statistically significant(P<0.005).There was no significant difference among the other different syndrome groups(P>0.005).4.The incidence of MACE in GRACE high-risk group(>140 points)was higher than that in medium-risk group(109-140 points)and low-risk group(<109 points),the incidence of MACE in high RDW group(>13%)was higher than that in low RDW group(<13%),which were statistically significant(P<0.05).5.Taking the occurrence of MACE as the dependent variable,Logistic regression analysis was carried out.Using the forward step method,the independent variable’s entering the equation included diabetes,smoking history,cTnT,Cr,and those not entering the equation group included hypertension,hyperlipidemia,TCM syndrome type,heart rate,systolic blood pressure,diastolic blood pressure,CK,CK-MB,LDH,WBC,RBC,RDW,PLT,GRACE scores.6.For all patients of unstable angina in this study,the AUC of GRACE and RDW were 0.670 and 0.620.The results were statistically significant(P<0.05).In heart qi deficiency group,AUC of GRACE and RDW were 0.640 and 0.668.In heart blood stasis group,AUC of GRACE was 0.783.The results above were statistically significant(P<0.05).The other AUC values were not statistically significant(P>0.05).Conclusion1.376 patients with unstable angina were mainly of phlegm stagnation in heart vessel type and heart qi deficiency type in this study.2.The patients with deficiency of heart qi had higher GRACE scores and higher risk of MACE comparing to patients with qi stagnation in chest and phlegm stagnation in heart vessel.The patients with heart and kidney yang deficiency had a higher RDW level comparing to patients with phlegm stagnation in heart vessel.3.RDW levels was correlated with the GRACE score of patients with deficiency of heart qi and phlegm stagnation in heart vessel.Compared GRACE scores>140 with GRACE scores≤140,the risk of MACE was significantly higher.Level of RDW>13%compared with RDW levels≤13%had higher risk of MACE.4.Diabetes,smoking,cTnT and Cr were risk factors of MACE of UA patients within 30 days.5.Grace score and RDW can be used as independent predictors of MACE risk in 30 days of UA patients with some of syndrome types.Grace score has a good prognosis evaluation ability in patients with heart blood stasis syndrome,a general effect in patients with heart qi deficiency syndrome,and no evaluation ability in patients with other syndrome types.RDW has a general prognosis evaluation ability in patients with heart qi deficiency syndrome,and no evaluation ability in patients with other syndrome types Assess capacity.