Relationship Between H2FPEF Score And SYNTAX Score In Patients With Non-segment ST Elevation Acute Coronary Syndrome

Background and ObjectiveWith the improvement of medical and health care,as well as the development of science and technology,more and more medical problems have being gradually broken through。However,the incidence and mortality of related diseases due to poor living and eating habits,as with work stress and emotional stress has not decreased.Cardiovascular disease is still the main reason that threatens the health of residents in China,and is gradually showing a younger trend.Unstable angina pectoris and non-segment ST elevation myocardial infarction are collectively known as Non-ST Segment Elevation Acute Coronary Syndrome,which takes up to 75% patients of the acute coronary syndromes.Unlike ST-segment elevation myocardial infarction patients,not all NSTE-ACS patients need early invasive treatment.For low-risk patients,drug conservative treatment often benefits more.But for high-risk patients,early intervention can significantly reduce the incidence of adverse cardiovascular events than conservative treatment.Therefore,early risk stratification and early identification of high-risk groups are particularly critical to improve the life quality and prognosis of patients.SYNTAX score is a scoring tool for assessing the severity of coronary lesions on the basis of coronary angiography,while H2FPEF score is a non-invasive score.It was originally used for HFpEF patients to identify cardiogenic dyspnea and other causes of dyspnea.At present,there are few researches on the relationship between SYNTAX score and H2FPEF score in patients with non-STsegment elevation acute coronary syndrome.Therefore,this study systematically analyzes the relationship between H2FPEF score and SYNTAX score in patients with NSTE-ACS,aiming to identify high-risk groups early and improve the prognosis of patients through a noninvasive scoring tool.Materials and methodsParticipants: A total of 118 patients with NSTE-ACS diagnosed by coronary angiography were enrolled in our hospital from January 2019 to December 2019.The basic clinical data of the patients were collected on the day of admission,and other baseline data.Fasting Venous blood samples were collected in the morning of the second day after admission to improve the related hematological,biochemical,immunological,myocardial enzyme and other related indicators.Two experienced ultrasound doctors use PHILIPS to measure echocardiography results.The H2FPEF value of each patient was calculated at admission.According to the results of coronary angiography,SYNTAX score system was used to evaluate the degree of coronary artery disease.According to SYNTAX score,the patients were divided into low SYNTAX score group(low SS group,SS score ≤ 22)and high SYNTAX score group(high SS group,SS score > 23).Results(1)The average age of patients in the high SS group was significantly higher than that in the low SS group,and the difference was statistically significant.The prevalence of diabetes,hypertension and atrial fibrillation and BMI in the high SS group were significantly higher than those in the low SS group,and the difference was statistically significant.There was no significant difference in gender and smoking history between the two groups.(2)The Nt-proBNP value of the patients in the high SS group was significantly higher than that in the low SS group,and there was no significant statistical difference in the other laboratory indexes.(3)The LVEF of the high SS group was significantly lower than that of the low SS group,compared with the low SS group,the average H2FPEF score of the patients in the high SS group was significantly higher,and the difference was statistically significant.(4)The correlation analysis showed that there was a significant positive correlation between H2FPEF score and SYNTAX score(r=0.828,Pr=0.001),and the difference was statistically significant.(5)The H2FPEF score and left ventricular ejection fraction were found to be independent predictors of high SS score.When the cutoff value of H2FPEF score was3.5,the predicted SS score was high,with a sensitivity of 84.6 % and a specificity of88.6 %(AUC: 0.926;95 % CI: 0.880-0.971;p < 0.001);When the boundary value of LVEF was 52.5 %,the predicted SS score was high,with a sensitivity of 79.7 % and a specificity of 74.4 %(AUC: 0.853;95 % CI: 0.783-0.923;p < 0.001).ConclusionThe H2FPEF score of patients with NSTE-ACS is significantly positively correlated with the SYNTAX score.This can be used to evaluate the severity and complexity of NSTE-ACS patients,to help identify high-risk patients as soon as possible,and to formulate the best treatment strategy.