Correlation Between Red Blood Cell Distribution Width And SYNTAX Score In Evaluating The Degree Of Coronary Artery Disease In Patients With Stable Coronary Artery Disease

Objective: 1.To further explore the relationship between red blood cell distribution width(Red blood cell distribution width-CV,RDW-CV)and stable coronary artery disease(Stable coronary artery disease,SCAD).2.The SYNTAX score was used to evaluate the coronary vascular lesions in patients with stable coronary artery disease(SCAD),and the correlation between RDW-CV and SYNTAX score was explored,so as to provide the basis for the guidance of clinical diagnosis and treatment by RDW.Methods: Patients who underwent coronary angiography in the Department of Cardiovascular Medicine of our hospital from December 2017 to May 2020 and whose general clinical data were complete after inclusion and exclusion criteria were selected.A total of 194 patients in the SCAD group were selected according to the calculation results of sample size and diagnostic criteria.According to the requirement that the sample size of the control group should be greater than the sample size of the case group in the retrospective case-control mismatch study,194 cases in the control group and non-CAD group were selected.Age,body mass index(BMI),smoking history,alcohol consumption history,history of hypertension,history of diabetes,creatinine(CREA),blood urea(UREA),Uric acid(URIC),fasting blood glucose(FBG),Total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),white blood cell count(WBC),red blood cell count(RBC),hemoglobin(HGB),blood platelet count(PLT),RDW-CV and coronary angiography results were recorded in two groups.In addition,the SCAD group was divided into three groups according to the SYNTAX score(online SYNTAX score system: www.syntaxscore.com)based on the results of coronary angiography,including127 cases in mild group(0-22 points),28 cases in moderate group(23-32 points)and 39 cases in severe group(≥33 points).SPSS 20.0 and Graph Pad PRISM 8 were used for statistical analysis to compare the baseline data and RDW-CV between the SCAD group and the non-CAD group.Binary Logistic regression analysis was performed to determine the influencing factors of SCAD,and RDW-CV was used to predict the ROC curve of SCAD patients.Diagnostic value was obtained.At the same time,the general data and RDW-CV level of the three groups in the SCAD group were compared for statistical differences in the severity of coronary artery disease,and the correlation between RDW-CV and SYNTAX score was analyzed.Multiple linear regression analysis was conducted to determine the influencing factors of SYNTAX score.Results:1.Baseline data comparison between the two groups: there were no statistically significant differences in age,gender,smoking history,drinking history,history of hypertension,history of hyperlipidemia,history of peripheral atherosclerosis,history of stroke,history of hyperuricemia,CREA,FBG,TBIL,ALT,AST,TG,LDL-C,RBC,HGB and PLT between the two groups(P > 0.05).There were statistically significant differences in diabetes history,WBC,EF,HDL-C,NEUT#,MONO#and RDW-CV(P < 0.001).2.Multivariate Logistic regression analysis showed that RDW-CV was a predictor of SCAD(P < 0.001),and HDL-C was a protective factor of SCAD(P < 0.01).3.The ROC curve analysis indicated that the area under the ROC curve of RDW-CV was0.646(95%CI: 0.592 ～ 0.700),the cut-off value of RDC-CV was 12.55%,and the sensitivity and specificity of RDC-CV were 0.912 and 0.304,suggesting that RDW-CV had certain diagnostic value.4.Comparison of general data among the SCAD group and the three groups on the degree of coronary artery disease: There were no statistically significant differences in age,gender,smoking history,alcohol consumption history,history of hypertension,history of diabetes,history of hyperlipidemia,history of peripheral atherosclerosis,history of stroke,history of hyperuricemia,BMI,CREA,UREA,UA,AST,TC,HDL-C,LDL-C,WBC,RBC,HGB,and PLT(P > 0.05).There were positive statistically significant differences in FBG,TBIL,ALT,TG,EF and RDW-CV(P < 0.05).5.The correlation analysis results of RDW-CV and SYNTAX score in SCAD group showed that there was a positive correlation between RDW-CV and the Spearman correlation of SYNTAX score(r=0.335,P < 0.001).6.The results of multiple linear regression in SCAD group showed that EF was a negative predictor of SYNTAX score,while RDW-CV was a risk factor affecting SYNTAX score(P <0.05).Conclusions:(1)Elevated RDW level may be a predictor of SCAD and has certain diagnostic value.(2)RDW and SCAD SYNTAX score evaluation in patients with coronary artery disease severity is positively related to,has a certain predictive value.