| Objective:To study the correlation of ankle-brachial index(ABI),brachial ankle pulse wave velocity(Ba-PWV) and the severity of acute coronary syndrome(ACS),searching for the value of ABI and Ba-PWV during the development of acute coronary syndrome,so that we can offer useful data and clue to the prevention and treatment of acute coronary syndrome.Method:Using the retrospective case analysis,collecting 220 patiens admitted in cardiology department from Augest,2007 to Augest,2008,who under went coronary artery angiography(CAG).There were 151 male patients and 69 female ones,age from 30 years old to 87 years old(59.09±11.17).All of them were measured with Brachial ankle pulse wave velocity (Ba-PWV),ankle-brachial index(ABI),brachial systolic blood pressure,diastostic blood pressure and pulse pressure.At the same time,patients preprandial was examed by routine assay, the essential hypertension history,diabetes history and smoking history were recorded.The patients were divided into normal group and ACS group by the result of CAG.Coronary artery score(Gensini score)was calculated for assessing the severity of coronary artery stenosis. According to the number of suffered coronary artery,patients were divided into one-vessel pathological,two-vessel athological and three-vessel pathological;patients were also divided into two group by more or less than 60 years old,and the score of ABI more or less than 0.9,the value of Ba-PWV higher or less than 1400cm/s.Results:With the reducing of ABI or increasing of Ba-PWV,the prevalence of ACS was increasing.With the patients getting older,the case of two-vessel pathological and three-vessel pathological were obviously increasing.In the group of ABI≤0.9,the percentage of ACS and three-vessel pathological is much higher.(87.3%vs50.3%,54.5%vs16.4%P＜0.001),the score of coronary artery stenosis is much higher(P＜0.001)..In the group of Ba-PWV≥1400cm/s,the percentage of ACS and two-vessel pathological three-vessel pathological are much higher. (71.2%vs64.9%,26.0%vs10.8%,32.2%vs13.5%P＜0.001),the score of coronary artery stenosis is much higher(P＜0.001).ABI joint Ba-PWV forecast the happy of ACS have higher specificity(95.6%vs90.1%vs51.1%),accuracy(56.2%vs54.3%53.6%) and positive predictive value(88.9%vs85.5%vs62.1%)than each of them.We chose Gensini score as the dependent variable,chose every dangerous factors as the independent variables,using the Bivariate correlations to analyze.The results shown that the degree of coronary artery stenosis had positive correlation with the Ba-PWV,essential hypertension history,diabetes history,age and smoking history(r=0.196-0.363,p＜0.01);had positive correlation with TC,apoB,FBS,Ba-PWV,UA, hs-CRP,FIG.(r=0.161-0.379,P＜0.05).had negative correlation with ABI(r=-0.201,P＜0.001), HDL-C,apoA-I,DBP(r=-0.167—0.221,P＜0.05).After the multiple stepwise regression,we got that ABI Ba-PWV,age and smoking history were the best predictor of the severity of coronary artery stenosis,without the influence of essential hypertension history,diabetes history,SBP, PP,FBS,hs-CRP,FIG.Conclusion:1.ABI and the Ba-PWV is a better reflection of arteriosclerosis parameters of non-invasive examination,had clodely correlation with the severity of coronary artery stenosis.2.Lower ABI may be a valuable predictor of ACS,B-aPWV low while non-significant predictors of ACS,low ABI Combined with high-Ba-PWV has more high-risk.3.ABI,B-aPWV,age and smoking and the severity of coronary artery stenosis in patients with ACS have some relevance,the severity of coronary artery stenosis had negative correlation with ABI,and had positive correlation with the Ba-PWV.4.the decreasing of ABI had something to do with age,diabetes history and smoking,the increasing of Ba-PWV had something to do with age,the histoy of HBP,diabetes history and smoking. |
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