The Relationship Between Coronary Artery Calcification Score,Triglyceride Glucose Product Index And Coronary Multivessel Disease In Patients With Acute Coronary Syndrome

Background:Acute coronary syndrome(ACS)refers to the acute ischemic heart syndrome caused by the formation of fresh thrombi secondary to imstable atherosclerotic plaques in the coronary arteries.ACS combined with multivessel coronary artery disease is defined as ACS patients with two or more epicardial branch stenosis of more than 2mm in diameter exceeding 70%.The condition of ACS patients with multivessel disease is complicated,which has adverse effects on the function of vital organs and the short-term or long-term prognosis.Coronary artery calcification score(CACS)is a non-invasive way to quantify coronary artery calcification using computed tomography(CT).It is of great significance to assess the burden of atherosclerotic plaque and predict the occurrence of acute myocardial infarction.Insulin resistance(IR)refers to the need to maintain normal glucose tolerance with a higher than normal blood insulin release level,indicating that the body’s tissues have decreased ability to process glucose with insulin.Insulin resistance plays an vital role in the occurrence and development of cardiovascular diseases.In ACS patients,insulin resistance can increase the vulnerability of plaque,especially independently related to plaque calcification.Triglyceride glucose product(TyG)index is the product of triglycerides and fasting blood glucose,and is a new indicator that can reflect insulin resistance.Elevated TyG index can predict the progression of coronary artery calcification and is an independent predictor of the progression of coronary artery calcification.This study intends to analyze and explore the relationship between CACS,TyG index and coronary multivessel disease in patients with acute coronary syndrome,and to provide help for the early identification,diagnosis and treatment of patients with complex coronary artery heart disease.Objective:By collecting information on patients with multivessel coronary artery disease and non-multivessel disease,the baseline data of the two groups of research subjects were compared;Compared the differences of CACS and TyG index between the two groups to determine whether the two indexes were related to multivessel coronary disease and to evaluate whether CACS and TyG index had diagnostic value in multivessel coronary disease.Through the study on the relationship between CACS,TyG index and ACS patients with multivessel coronary disease,it provides help for the early identification,diagnosis and treatment of patients with multivessel coronary disease.Methods:A total of 123 patients who were diagnosed with ACS and had coronary CTA and coronary angiography jfrom August 2018 to July 2020 in the Department of Cardiology,Shandong University Second Hospital were selected for retrospective analysis.According to the results of coronary angiography for the multivessel coronary artery disease group and the non-multivessel coronary artery disease group,flie general data,laboratory indicators,cardiac color Doppler ultrasound,CACS,TyG index and Gensini score were compared between the two groups.Pearson or Spearman correlation analysis clarifies the correlation between CACS and TyG index and coronary artery multivessel disease in patients with ACS.Logistic regression analysis explores the independent risk factors leading to coronary artery disease in patients with ACS.ROC curve to evaluate the diagnostic value of CACS and TyG index for coronary multivessel disease.Results:1.Compared with multivessel disease group and non-multivessel disease group,there were no statistically sigaificant differences in age,gender,smoking,drinking,history of hypertension,history of diabetes,the use of lipid-lowering drugs,cystatin C,BNP,troponin,left atrium size,left ventricular end-diastolic volume,left ventricular ejection fraction and E/E’(P﹥O.05);patients with multivessel disease had higher admission blood pressure and faster heart rate,fasting blood glucose,triglyceride,homocysteine,uric acid were higher(P<0.05).2.Compared wife the non-multivessel disease group,the total CAC score of the multivessel coronaiy artery disease group was much higher than that of the non-multivessel disease group(P<0.001);CACS(LM score,LAD score,LCX score and RCA score)were all higher than those in the non-multivessel disease group(P<0.01).In addition,the TyG index and Gensini score in the multivessel disease group were both high in the non-multivessel disease group(P<O.Ol).3.Correlation analysis of multivessel disease in patients with ACS showed that CACS and TyG index are related to coronary multivessel disease: CACS(r=QA32,P < 0.001),TyG index(r=0.33 Q,P<0.001).4.Logistic regression analysis with CACS and TyG index as independent variables and whether it is multivessel coronary artery disease as dependent variable found that CACS(OR=1.004,P<0.01)and TyG index(OR=2.646,P < 0.05)are independent risk factors for coronary artery disease of multivessel disease.5.ROC curve analysis of the diagnostic value of CACS and TyG index for multivessel coronary artery disease: the area under the ROC curve of CACS for multivessel coronary artery disease is0.749,95% CI is 0.662-0.837,the sensitivity is 69.4%,and the specificity is: 77.0%;the area under the ROC curve of TyG index for multivessel coronary artery disease is 0.691,95% CI is0.597-0.784,the sensitivity is 79.0%,and the specificity is: 50.8%;the area under the ROC curve of CACS combined with TyG index for coronary multivessel disease is 0.802,the 95% CI is 0.725.0.879,the sensitivity is 62.9%,and the specificity is 83.6%.Conclusions:1.ACS patients with multivessel disease have hitler CACS,TyG index,and coronary Gensini scores;2.CACS and TyG index are related to the occurrence of multivessel disease in ACS patients;3.CACS and TyG index are independent risk factors for multivessel disease in ACS patients;4.CACS combined with TyG index has better predictive value for multivessel coronary disease;...