| Objective To investigate the relationship between the frontal QRS-T angle(FQRS-T angle)and the severity of coronary artery disease(CAD)in patients with acute myocardial infarction(AMI),as well as its predictive value for major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI).Methods A total of 300 first-time AMI patients who underwent PCI between January 2018 and January 2020 were included in this study.The F-QRS-T angle and Gensini score were calculated for each patient,and they were followed up for more than 3 years.According to the Gensini score system,the subjects were divided into two groups: the mild coronary artery lesions group(Gensini score < 25 points)and the severe coronary artery lesions group(Gensini score ≥ 25 points).The study analyzed the difference in F-QRS-T angle between the two groups,performed a Spearman correlation analysis between F-QRS-T angle and the degree of coronary artery stenosis.ROC curves were drawn to explore the diagnostic efficiency of F-QRS-T angle for severe coronary artery lesions.Then,the subjects were divided into MACE group and non-MACE group according to whether MACE occurred during the follow-up period,with intergroup comparisons made,and the correlation between F-QRS-T angle and MACE was analyzed.Multivariate logistic regression analysis was used to determine the risk factors affecting the occurrence of MACE in patients with AMI after PCI.ROC curvs were drawn to explore the diagnostic efficiency of F-QRS-T angle for MACE and to determine the diagnostic threshold.Results 1.F-QRS-T angle was significantly higher in the severe coronary artery lesions group compared to the mild coronary artery lesions group(P<0.05),and it was positively correlated with coronary artery lesions severity(rs = 0.583,P<0.01).2.ROC curve analysis showed that the optimal cutoff value of F-QRS-T angle for diagnosing severe coronary artery lesions was 76.5°,with a sensitivity of 42.1% and a specificity of 90.1%,and the area under the ROC curve(AUC)was 0.665(95%CI:0.604-0.725,P < 0.05).3.Age,smoking rate,hypertension prevalence,diabetes prevalence,neutrophil count(NEUT),C-reactive protein(CRP),homocysteine(HCY),total cholesterol(TC),triglycerides(TG),and low-density lipoprotein cholesterol(LDL-C)were higher in the severe coronary artery lesions group(P<0.05).4.F-QRST angle,Gensini score,age,smoking rate,hypertension prevalence,diabetes prevalence,dyslipidemia prevalence,white blood cell(WBC),NEUT,HCY,CRP,and serum creatinine(Cr)levels were significantly higher in the MACE occurrence group(P<0.05),and there was a positive correlation between F-QRS-T angle and the occurrence of MACE(rs = 0.498,P<0.001).5.Multiple logistic regression analysis revealed that F-QRS-T angle(OR: 1.075,95%CI: 1.037-1.113),age(OR: 1.224,95%CI: 1.093-1.371),smoking(OR: 10.36,95%CI: 1.369-78.406),combined diabetes(OR: 7.351,95%CI: 1.228-44.012),combined dyslipidemia(OR: 9.42,95%CI: 1.345-65.972),NEUT(OR: 1.451,95%CI: 1.035-2.036),Cr(OR: 1.119,95%CI: 1.046-1.197),and Gensini score(OR: 1.023,95%CI: 1.001-1.045)were independent predictors of MACE occurrence(P<0.05).6.The optimal cutoff value of F-QRS-T angle for diagnosing MACE occurrence in AMI patients was 85.5°,with a sensitivity of 78.6%,a specificity of 94.6%,and an AUC of 0.914(95%CI: 0.858-0.970,P<0.05).Conclusion 1.F-QRS-T angle of AMI patients is positively correlated with the severity of coronary artery disease.2.F-QRS-T angle is a simple,fast,non-invasive evaluation index that has certain diagnostic value for severe coronary artery lesions,which can be used to evaluate the degree of coronary artery lesions in AMI patients.3.F-QRS-T angle is an independent predictor of MACE occurrence in AMI patients after PCI.4.Determining the possible diagnostic threshold of F-QRS-T angle for predicting the risk of MACE occurrence may help clinical doctors to take corresponding intervention strategies to improve the prognosis of AMI patients. |
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