The Relationship Between Red Blood Cell Distribution Width And Coronary Lesions And Prognosis Of Acute Coronary Syndrome In Emergency PCI

Objective:To investigate the correlation between the erythrocyte distribution width level(RDW)and the degree of coronary artery disease in patients with acute coronary syndrome(ACS),and the correlation between RDW and the prognosis of patients who have undergone PCI,and then to use ACS as a simple index of blood To initially assess the possibility of cardiovascular accidents,the severity of the disease,and the prognosis,and analyze its role in the mechanism of cardiovascular disease.Methods: The plan is to select the patients who have undergone PCI for ACS from April 2017 to January 2018,the only tertiary hospital in Central City,which is the Central Hospital Hospital,and 60 inpatients with RDW and color Doppler ultrasound have been determined as the experimental group.ACS is divided into three major categories: ST elevation myocardial infarction(STEMI);non-ST elevation myocardial infarction(NSTEMI);unstable angina(UA).According to the results of the coronary angiography of patients,the Gensini scores were quantified according to the severity of the lesions and were divided into mild coronary lesions(0-20 points);moderate coronary lesions(21-44 points);severe Coronary lesions(45-80);extremely severe coronary lesions(81 and above).We then compared the differences in RDW levels in different coronary lesion groups and further explored their relevance.According to the median test results of the RDW standard range,the first measurement within 24 hours after admission was the high-level variation coefficient of red blood cell distribution width(RDW≥13.5%)and the low-level variation coefficient of red blood cell distribution width(RDW<13.5%),meanwhile,collect general data(age,sex,smoking history and related medical history,such as hypertension,diabetes)of patients with different red blood cell distribution widths,and fasting blood glucose,serum creatinine,triglyceride,Differences in total cholesterol,low-density lipoprotein,high-density lipoprotein,serum uric acid,N-terminal pro-brain natriuretic peptide(BNP),C-reactive protein,and ejection fraction(LVEF).The patients were followed up to the 2018-01 cardiovascular adverse event(MACE)and divided into MACE and MACE.Through a single-factor analysis,statistically significant factors,that is,risk factors,were obtained,and then multiple risk factors were grouped for multivariate regression analysis.On the other hand,according to the RDW results measured in the human hospital for the first time 24 h,there were two groups,the low-level RDW group and the high-level RDW group,and whether there was any difference in the occurrence of MACE between the two groups during the follow-up period.To explore the correlation between red cell distribution width and MACE.SPSS20.0 was used for statistical analysis.The experimental results were expressed as data and graphs.Quantitative data were expressed as mean±standard deviation.Comparisons between groups were performed using t-test and analysis of variance.Spearman was used for the quantitative variables.P<0.05 was used as the significant difference.Logistics was used for univariate or multivariate correlation analysis.Results: 1.General data and main experimental indicators of each RDW level: TC in high-level RDW group was 5.38±1.15 mmol/L,and TC in low-level RDW group was 4.61±1.02 mmol/L.There was a statistically significant difference between the two groups.(t=-2.743,P=0.008).The Gensini score of the high-level RDW group was 54.17±27.21.The Gensini score of the low-level RDW group was 36.55±22.82.The difference between the two groups was statistically significant(t=-2.709,P=0.009).The RDW at different levels was There was no significant difference in age,gender,hypertension,diabetes,obesity,smoking,uric acid,hemoglobin(Hb),C-reactive protein(CRP),brain natriuretic peptide(BNP),and ejection fraction(LVEF).P>0.05;2.Independent risk factors for coronary artery lesions of age,gender,diabetes,hypertension,smoking,and obesity;3.Levels of RDW in each Gensini score group: Gensini(mild)<Gensini(moderate)< Gensini(heavy)<Gensini(very severe),the difference was statistically significant,P <0.05;2.Gensini score was positively correlated with RDW level,correlation coefficient r = 0.583,P <0.001,that is,RDW was positively correlated with coronary lesions;4.Patients with MACE: including heart failure,recurrent myocardial infarction,recurrence of angina,etc.,high RDW group> low level group RDW,P <0.05,the difference was statistically significant,but the RDW in cardiac death No difference in level,P>0,05.Conclusions:1.RDW is positively correlated with the severity of coronary lesions in patients with ACS.2.RDW is an important predictor of prognosis in patients with ACS who have undergone emergency PCI.High levels of RDW have a poor prognosis.