Relationships Among Coronary Angiography Gensini Score,Leaman Score And Ultrasonography Of Peripheral Arterial Plaque As Well As Its Predictive Value

Objective:To investigate the correlation between the ultrasonic features of peripheral artery plaques(carotid bifurcation plaque,femoral artery plaques)and Gensini score,Leaman score and analyze the clinical predictive value of peripheral plaques in severe coronary heart disease.Method:A total of 437 patients with suspected coronary heart disease admitted to the Affiliated Hospital of Qingdao University from October 2018 to December 2019 were retrospectively selected and perfected with fasting routine laboratory tests,carotid and femoral artery ultrasound and coronary angiography(coronary angiography,CAG)examinations.And we calculated coronary artery calcification Scores(Gensini Scores,Leaman Scores),carotid artery Crouse Scores and Grade Scores.According to the CAG results,the patients were divided into CHD group(303 cases)and normal angiography group(134 cases).Then according to the number of lesions,the coronary heart disease group was further divided into single-vessel group(139 cases),double-vessel group(80 cases)and multi-vessel group(84 cases).And the baseline data,differences in carotid ultrasound performance and plaque detection rate between the groups were compared,and the correlation between Crouse Scores and coronary artery calcification Scores was analyzed by Spearman’s rank correlation coefficient.The receiver operating curve(ROC)was used to analyze and predict carotid bifurcation plaque,femoral artery plaque,and the combination of the two to analyze and predict severe coronary heart disease.The proportion of carotid artery plaque and the differences in baseline data of patients in the CHD group and the normal angiography group are compared,and the correlation between the Crouse score and the Gensini score and Leaman score in the coronary heart disease group is analyzed.According to Grade scores,149 patients with abnormal carotid bifurcation were divided into 5 groups.The differences of baseline data and coronary artery calcification scores between groups were compared,and the influence of femoral artery plaque on coronary artery calcification scores was also studied.The main statistical methods included One Way ANOVA,chi-square test,LSD-T,H test.Use the receiver operating curve(ROC)to analyze the predictive performance of carotid bifurcation plaque,femoral artery plaque and the combination of both for severe coronary heart disease,and analyze the sensitivity,specificity and the area under the curve(AUC)of the result.Result:1.The proportion of carotid artery plaque in the CHD group [133 cases(43.89%)] is higher than that in the normal coronary angiography group [38 cases(28.36%)](P<0.05).Among them,the multiple-vessel group [50 cases(59.52%)] is higher than the doublevessel group [31 cases(38.75%)] and the single-vessel group [52 cases(37.41%)](P<0.05).There is no statistical difference between single-vessel and double-vessel group(P>0.05).2.Crouse score is positively correlated with the Gensini score(r=0.5523,P<0.05)and Leaman score(r=0.4832,P<0.05).3.Compared with the absence of carotid bifurcation plaque or thickness≤20mm,Gensini score and Leaman score are higher when the thickness of the plaque is more than20 mm,and the difference is statistically significant(P<0.05).4.Compared with the absence of femoral artery plaque,the coronary artery calcification score was higher in the presence of femoral artery plaque,and the difference was statistically significant(P<0.05).5.ROC curve analysis of carotid bifurcation plaque and femoral artery plaque predicts AUC for severe coronary heart disease respectively is 0.7394 and 0.6826.Combining the two can increase AUC to 0.7686.Based on the plaque at the bifurcation of the carotid artery,the sensitivity of predicting the severity of coronary heart disease is 89.19% and the specificity is 58.70%;based on the femoral artery plaque,the sensitivity is 81.08% and the specificity is 55.43%.The sensitivity and specificity of presence of femoral artery plaque and carotid bifurcation plaque were 93.33% and 60.38% respectively.Conclusion:1.There is a positive correlation between Crouse score and coronary artery calcification.2.Carotid bifurcation plaque and femoral artery plaque are correlated with coronary artery calcification.When the thickness of carotid bifurcation plaque is more than 20 mm,the degree of coronary artery calcification is more serious.3.Carotid bifurcation plaque is more valuable in predicting severe coronary heart disease than femoral artery plaque.Combining the two has greater predictive value.