Correlation Between Partial Index And Ratio Of Blood Lipid Profile And Severity Of Coronary Artery Disease In Patients With Acute ST-segment Elevation Myocardial Infarction

Objective:To explore the relationship between some indexes and their ratios in the blood lipid profile of patients with acute ST-segment elevation myocardial infarction(STEMI)and the severity of coronary artery disease,and to provide evidence for the prevention and treatment of STEMI.Methods:221 patients who accepted coronary angiography(CAG)due to chest pain at the First Affiliated Hospital of University of Science and Technology of China during September 2017 to September 2018,including 174 patients with STEMI diagnosed as the experimental group,47 patients with normal coronary angiography as a control group,General patient data(gender,age,history of diabetes,history of hypertension,history of smoking,height,weight,electrocardiogram)were recorded at admission,and relevant laboratory tests were performed in the emergency department(percentage of neutrophils,percentage of lymphocytes,creatinine,troponin,D-dimer),the Gensini score for each STEMI patient was calculated from the CAG results to measure the severity of coronary lesions.The next day,all patients were tested for fasting blood lipid(total cholesterol,triglycerides,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,very low-density lipoprotein)for differential analysis in both groups;Pearson correlation analysis between some indicators and ratios of blood lipids in all STEMI patients and Gensini score,Finally,multiple linear regression analysis was used to further screen some indicators and ratios of hemorrhagic lipid profiles which were most relevant to the severity of coronary lesions in STEMI patients.All STEMI patients were classified according to CAG results.For the single-vessel disease group,double-vessel disease group and three-vessel disease group,differential analysis of some indicators and ratios in blood lipid profiles of three groups of patients.Results:Difference analysis between the experimental group and the control group: the age,hypertension,smoking,D-dimer,troponin,TC,LDL-C were statistically significant(P< 0.05);Correlation analysis of some indicators and ratios in the lipid profile of all STEMI patients with Gensini score: TC,LDL-C,TC/TG,TG/LDL-C,LDL-C/HDL-C were correlated with Gensini score(P < 0.05).Among them,TC,LDL-C,TC/TG,LDL-C/HDL-C were positively correlated with Gensini score.TG/LDL-C was negatively correlated with Gensini score;LDL-C/HDL-C was positively correlated with Gensini score after multivariate linear regression analysis(β=0.383,P=0.020);All STEMI patients were divided into single-valued disease group,double-vessel disease group,and three-vessel disease group according to CAG results.Differential analysis was performed on some indicators and ratios in the lipid profiles of the three groups: The difference of TC and LDL-C between the two-vessel disease group and the three-vessel disease group was statistically significant(P<0.05).Conclusion:The plasma TC,LDL-C,TC/TG,LDL-C/HDL-C in patients with STEMI were positively correlated with the severity of coronary lesions.It is a risk factor for coronary artery disease;The plasma TG/LDL-C in patients with STEMI was negatively correlated with the severity of coronary lesions.It is a protective factor for coronary lesions;There was no significant correlation between plasma LDL-C/HDL-C and the number of coronary lesions in STEMI patients;Plasma LDL-C/HDL-C in STEMI patients is a good indicator to evaluate the severity of coronary lesions,but it is not an indicator to evaluate the number of coronary lesions;Plasma LDL-C/HDL-C is an important reference index for blood lipid management in STEMI patients.