Study Of Red Blood Cell Distribution Width,hematocrit And Coronary Heart Disease In Perimenopausal Women

Background The risk of coronary heart disease is significantly increased in perimenopausal women due to the decrease in ovarian function and estrogen production.Red blood cell distribution width（RDW）is considered to be an independent risk factor for the development of coronary heart disease and is closely related to the onset and prognosis of coronary heart disease,while the relationship between hematocrit（HCT）and the development of coronary heart disease is not yet universally established,and there are significant differences between men and women.Therefore,it is important to investigate the relationship between the occurrence of perimenopausal women with coronary heart disease,the width of red blood cell distribution and red blood cell pressure,and to provide further understanding of the occurrence and development of coronary heart disease in perimenopausal women.Objective To investigate the correlation between red blood cell distribution width and hematocrit and the development of coronary heart disease in perimenopausal women,to evaluate whether red blood cell distribution and hematocrit are independent risk factors for the development of coronary heart disease in perimenopausal women,and to provide assistance for the early identification and diagnosis of coronary heart disease in perimenopausal women.Methods A total of 170 perimenopausal women with complete data who attended Puyang People’s Hospital from October 2019 to December 2021 with coronary CTA or（and）coronary angiography were selected for retrospective analysis.Comparing the general information of the two study groups,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,glucose,triglycerides（TG）,total cholesterol（TC）,high-density lipoprotein（HDL）,low-density lipoprotein（LDL）,atherosclerosis index（LDL/HDL）,blood urea nitrogen（BUN）,uric acid（UA）,creatinine（Cr）,white blood cell count（WBC）,red blood cell count（RBC）,hemoglobin（Hb）,hematocrit（HCT）,mean red blood cell volume（MCV）,standard deviation of red blood cell distribution width（RDW-SD）,coefficient of variation of red blood cell distribution width（RDW-CV）,platelet count（PLT）,platelet distribution width（PDW）,mean platelet volume（MPV）,platelet pressure volume（PCT）,left ventricular end-diastolic anterior-posterior diameter（LVDd）,ejection fraction（EF%）,correlation with the development of coronary heart disease in patients was analyzed,logistic regression analysis was performed to find independent risk factors for the development of coronary heart disease in perimenopausal women,and ROC curves were used to assess their diagnostic value for coronary heart disease.Results1.Compared with the non-coronary heart disease group,the differences in age,weight,history of hypertension,history of dyslipidemia,TC,LDL,LDL/HDL,BUN,UA,Cr,RBC,Hb,HCT,MCV,RDW-SD,RDW-CV,PLT,PDW,MPV,PCT,and LVDd indexes between the two included groups were not statistically significant（all P > 0.05）,and patients in the coronary artery disease group had a history of diabetes at admission,higher blood glucose levels,ALT,AST,TG,WBC,and lower HDL and EF（all P < 0.05）.2.Logistic multiple regression analysis revealed that HDL（OR=0.237,P<0.05）was an independent protective factor against coronary heart disease in perimenopausal women.3.ROC curve analysis of the diagnostic value of blood glucose,ALT,AST,TG,WBC,HDL and EF on the development of coronary heart disease in perimenopausal women: the area under the ROC curve of ALT on the development of coronary heart disease was 0.673,95% CI: 0.592-0.553,sensitivity: 44.7%,specificity: 81.2%,and the best cut point was20.75 U/L.The area under the ROC curve for AST on the occurrence of coronary heart disease was 0.616,95% CI: 0.531-0.701,sensitivity: 49.4%,specificity: 76.5%,and the optimal cut point was 20.75 U/L.The area under the ROC curve for blood glucose on the occurrence of coronary heart disease was 0.55,95% CI: 0.463-0.637（P=0.262 > 0.5）.The area under the ROC curve for TG on the occurrence of coronary heart disease was 0.602,95% CI: 0.517-0.687,sensitivity: 51.8%,specificity: 69.4%,and optimal cut point of 1.765mmol/L.The area under the ROC curve of HDL for the development of coronary artery disease was 0.642,95% CI: 0.559-0.725,sensitivity: 20%,specificity: 61.2%,and the optimal cut point was 1.325 mmol/L.The area under the ROC curve of WBC for the development of coronary artery disease was 0.62,95% CI: 0.536-0.704,sensitivity: 72.9%,specificity: 50.9%,and optimal cut point of 5.325×10^9/L.The area under the ROC curve for EF on the occurrence of coronary heart disease was 0.609,95% CI: 0.525-0.694,sensitivity: 61.2%,specificity: 17.6%,and the optimal cut point was 61.5%.Conclusions1.No correlation between the occurrence of coronary heart disease in perimenopausal women and RDW,HCT,etc.2.The occurrence of coronary heart disease in perimenopausal women was correlated with patient’s history of diabetes,blood glucose level,ALT,AST,TG,WBC,HDL,and EF.3.HDL is an independent protective factor for perimenopausal women with coronary artery disease.