Clinical Risk Factors And Treatment Intervention Of Chest Pain In Patients With Non-obstructive Coronary Artery Disease

Objective :PET/CT quantitative blood flow imaging evaluation method is used to explore the obstructive coronary artery disease risk factors in patients with chest pain,by recording patients medications,follow-up Seattle chest pain scale,some patients review,PET/CT quantitative blood flow imaging evaluation of obstructive coronary artery lesions in patients with chest pain CFR check influence on prognosis of patients,in order to early interventions for coronary microvascular disease and improve its prognosis.Methods:Continuous in September 2018 to August 2020 because of chest pain the teda international hospital cardiovascular disease treatment,line of coronary angiography(coronary angiography,the CAG)has no obvious narrow lesions(< 50%)or coronary CT angiography(coronary CT angiography,CCTA)negatie results after checking it,and at the same time line of PET/CT quantitative determination of blood flow imaging coronary flow reserve(coronary flow reserve,CFR)in patients with suspected CMVD,finally in 99 cases,There were 31 males and 68 females,aged from 45 to 82 years,with an average age of(59.49±8.52)years.According to the CFR results of PET/CT measurement,CMVD group was diagnosed as the threshold value of CFR<2.0,and the other group was diagnosed as the control group.There were55 patients(10 males,45 females)with CMVD,and 44 patients(21 males,23females)in the control group.Basic clinical data of all subjects were recorded,and fasting elbow venous blood was extracted in the morning for the determination of total cholesterol(CHOL),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),fasting blood glucose(FBG)and serum creatinine(CRE).The image data of CAG and CCTA werecollected.CFR was determined by using adenosine triphosphate(ATP)drug load/resting dynamic imaging,and medication status of all patients was recorded.Seattle Angina Questionnaire SAQ was used for regular follow-up.SPSS19.0 statistical software was used for data analysis.Two-sample t test was used to analyze the measurement data,chi-square test was used to analyze the enumber data,and logistic regression analysis was used for multivariate analysis.Results:1.There were no significant differences between the two groups in age,BMI,total cholesterol,triglyceride,low-density lipoprotein,fasting blood glucose,serum creatinine,history of hypertension and diabetes mellitus,abnormal fasting blood glucose,smoking or not(P >0.05);2.The incidence of female patients in CMVD group was higher than that in control group [82%(45/55)vs.52%(21/44),P <0.05],and the high density lipoprotein(HDL-C)was lower than that in control group[(0.90±0.45)vs.(1.12±0.23),P <0.05].Binary Logistic regression analysis showed that female(OR= 4.411,95%CL:1.694-11.485,P <0.05)and low level of HDL-C(OR=7.772,95%CL: 1.646-36.706,P <0.05)might be risk factors.3.SAQ value of CMVD patients after treatment was significantly higher than before[(76.80±4.65)vs.(90.47±3.50),P=0.001<0.05],CFR was significantly improved compared with before review(1.57±0.42 vs.2.22±0.65,P =0.038<0.05).Conclusion:1.The incidence of CMVD in women is higher than that in men,and low HDL-C may be a risk factor;2.After drug therapy,chest pain symptoms,quality of life and functional status of CMVD patients were improved significantly.CMVD patients were improved significantly.