The Relationship Between Cardio Ankle Vascular Index,Ankle Brachial Index,Carotid Intima-media Thickness And Coronary Artery Disease

Objective To investigate the cardio ankle vascular index(Cardio-ankle vascular,index,CAVI),ankle brachial index(Ankle-Brachial Blood pressure Index,ABI)and carotid intima-media thickness(Intima-media,thickness,IMT)in the diagnosis of coronary heart disease.Methods From February 2015 ~2016 year in May in North China Polytechnic University Hospital Department of Cardiology for coronary artery angiography(Coronary angiography CAG)in 243 cases of patients,in accordance with the standards of the 164 cases,Gensini score according to the results of CAG,divided into coronary artery normal group(n=38,Gensini score of 0)and coronary artery disease group(n=126,Gensini score 0.5~160),according to the four percentile method of coronary artery disease patients were divided into 4 groups: group A(n=31,Gensini score 0.5~36),group B(n=32,Gensini score 36.1~78),group C(n=33,Gensini score of 78.1 ~117)and D group(n=30,Gensini score of 117.1~160).Routine medical records were collected for all selected subjects.Age,sex,height and weight were measured,and blood pressure was measured.Biochemical test results were collected and CAVI,ABI and IMT values were measured.Results The levels of total cholesterol(TC),high density lipoprotein(HDL-C)and fasting(HDL-C)were significantly higher in the normal group,group A,group B,group C and group D(P<0.05).Body mass index(BMI),triglyceride(TG),low density lipoprotein(LDL),low density lipoprotein(LDL),low density lipoprotein(LDL)LDL-C),Systolic blood pressure(SBP),diastolic blood pressure(DBP)were statistically different(P<0.05).CAVI,ABI and IMT were significantly different between the five groups(P<0.05)in the normal group,group A,group B,group C and group D,and the values of CAVI and IMT were increasing in the five groups,ABI values were decreasing in the five groups.The correlation between CAVI,ABI and IMT and Gensini score was analyzed.The results showed that CAVI and IMT were positively correlated with Gensini score,ABI was negatively correlated with Gensini score,the correlation coefficient r was 0.764,-0.695 and 0.702(P<0.05),respectively.CAVI and Gensini score More relevant.The sensitivity and specificity of C AVI in predicting coronary artery disease were 92.06% and 89.47% respectively.The sensitivity and specificity of IMT in predicting coronary artery disease were 88.89% and 92.11% respectively.ABI predicted the sensitivity of coronary artery disease and the sensitivity and specificity of coronary artery disease Specificity was 75.40%,92.11%.Compared with IMT,ABI,CAVI predict the sensitivity,false positive rate and negative value of the highest specificity,false negative rate is the lowest;CAVI positive likelihood ratio,crude agreement rates were 8.74,91.46%,ABI positive likelihood ratio,crude agreement rates were 9.56,79.26%,positive likelihood ratio,crude IMT the consistent rate were 11.27,89.63%,the lowest negative likelihood ratio among the three CAVI,consistent with the highest rate of crude,that is also the largest accuracy CAVI ruled out the possibility of coronary artery disease compared with ABI,IMT,prediction of coronary artery disease,compared with the three of Youden index was found CAVI maximum Youden index,indicating the best disease coronary CAVI screening effect,the authenticity of the largest.Comparing the Kappa coefficients of the three,we found that compared with IMT and ABI,the results of CAVI and CAG were in good agreeme nt.In conclusion,CAVI predicts coronary artery disease best.By using multivariate linear regression analysis of Gensini score and CAVI,IMT,ABI correlation,the results showedthat: Gensini score and CAVI,ABI is independently associated with ROC,CAVI curve of ABI in predicting the value of coronary artery disease,ROC found that the area under the CAVI curve was 0.821;ROC area under the ABI curve was 0.514;ROC area under the IMT curve was 0.734.The results show that the area under the CAVI curve is the largest,which indicates that C AVI is the most valuable predictor of coronary artery disease.The above results show that the value of CAVI in predicting coronary artery disease is higher than that of ABI and IMT.Conclusions With the severity of coro nary artery disease increased,CAVI,IMT increased trend,ABI showed a downward trend.Compared with ABI,IMT,CAVI and coronary artery disease degree more closely.