Study On The Correlation Between MHR,RDW Levels And Severity Of Coronary Atherosclerosis In Patients With ACS And Its Diagnostic Value

Objective:To study the correlation between monocyte/high-density lipoprotein cholesterol(MHR),red blood cell distribution width(RDW)and severity of coronary atherosclerosis in patients with acute coronary syndrome(ACS),and to analyze the diagnostic value of single and/or combined judgment of the two for the diagnostic of ACS.Aiming to improve the early detection rate and accuracy of ACS patients,and to provide certain guiding significance for early diagnosis,and improvement of prognosis in clinical practice.Methods:1.A total of 220 patients with chest pain and coronary angiography(CAG)in the Department of Cardiology of the second Hospital of Shanxi Medical University from September 2018 to December 2020 were collected retrospectively.Basic clinical data,blood cell analysis,biochemical indexes and CAG results(Gensini score)were collected and recorded.According to the clinical manifestations and CAG results,the patients were divided into ACS group and normal control group,the basic clinical data and MHR,RDW and other indexes of the two groups were compared,and the ACS group was divided into mild,moderate and severe disease groups according to the ternary of CAG result score,and the differences of MHR and RDW levels among different subgroups were further analyzed.2.Spearman correlation analysis was used to analyze the relationship between MHR,RDW and Gensini score,and to determine the relationship between the two indexes and the severity of coronary artery stenosis in ACS patients.3.The ROC curve was used to calculate the diagnostic value of MHR,RDW and their combined judgment for ACS,which provided an effective theoretical basis for clinical diagnosis.Results:1.Comparison of general data and serological indexes between ACS group and control group:There was no significant difference in age,sex,drinking history,body mass index(BMI),monocyte count(M),hemoglobin(HB),platelet(PLT),cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),serum creatinine(Scr)and uric acid(UA)between the two groups.The proportion of hypertension,diabetes,smoking,white blood cell count(WBC),glucose(Glu),homocysteine(Hcy),MHR and RDW in ACS group were significantly higher than those in normal control group(P<0.05),while high density lipoprotein cholesterol(HDL-C)level was significantly decreased(P<0.05).2.Changes of MHR and RDW levels in each subgroups of the ACS group:The level of MHR in severe group was significantly higher than that in mild group(P<0.05),and the level of RDW in moderate and severe disease group was significantly higher than that in mild group(P<0.05).3.Spearman orrelation analysis of MHR and RDW with Gensini score:Both MHR(r~a=0.372,P<0.05)and RDW(r~b=0.425,P<0.05)were positively correlated with Gensini score.And the higher MHR,RDW level was,the more severe the coronary stenosis degree was.4.Diagnostic value of MHR and/or RDW for ACS:ROC curve showed that the diagnostic efficiency of RDW(AUC=0.651,P<0.01)was slightly higher than that of MHR(AUC=0.637,P=0.001),Compared with the combined factors,the diagnostic efficiency was the highest when the two indicators were combined(AUC=0.700,P<0.01).When MHR,RDW and MHR+RDW were 0.435,12.65 and 3.673 respectively,the diagnostic efficiency was the highest(63.7%,65.1%,70.0%),the sensitivity was 41.4%,48.3%and71.7%,and the specificity was 82.7%,74.7%and 60.0%.The 95%confidence intervals of MHR,RDW and MHR+RDW were(0.563,0.711),(0.576,0.726)and(0.629,0.770).Conclusion:1.Both MHR and RDW values in the ACS group were significantly higher than those in the normal group,and the higher the two indexes were,the greater the Gensini scores.MHR and RDW were positively correlated with the degree of coronary artery stenosis,indicating that MHR and RDW,as new inflammatory indexes,could predict the degree of coronary artery lesions in patients with ACS.2.Both high MHR and RDW have clinical diagnostic value for ACS,and the diagnostic efficiency of RDW is slightly higher than that of MHR,and the diagnostic efficiency of joint judgment is the highest.Therefore,joint detection is beneficial to early propensity and even clear diagnosis of ACS.