| Objective :To investigate the correlation between residual cholesterol(RC)and TyG index and the severity of coronary artery lesions in patients with NSTE-ACS,and to analyse their predictive value for NSTE-ACS and provide a basis for its prevention and treatment.Methods:Two hundred and ninety-nine patients with NSTE-ACS who attended the cardiology department of our hospital from January 2020 to December 2021 were selected,and the Gensini score was based on the patients’ coronary angiography results,and the coronary severity was divided into a low-risk group(0-20 points,n=52),an intermediate-risk group(21-40 points,n=71),and a high-risk group(>40 points,n=176)according to the score,and another Fifty-nine patients with symptoms of chest pain and chest tightness on admission and clinically diagnosed as coronary atherosclerosis,stable angina or coronary stenosis were randomly selected as the control group.The differences in clinical data such as age,sex,body mass index(BMI),history of smoking,history of hypertension,history of diabetes mellitus,and other laboratory indices such as RC,TyG index,and lipid index were compared between the NSTE-ACS group and the control group,as well as between the subgroups.The Spearman method was used for correlation analysis.Multiple linear regression was used to analyze the relationship between RC,TyG index and Gensini score.Multifactorial logistic regression was used to analyze the risk factors for the occurrence of NSTE-ACS.The diagnostic value of RC,TyG index and the combination of the two for NSTE-ACS was assessed by making ROC curves.Results :(1)The RC level of 0.56(0.41,0.85)in the NSTE-ACS group was significantly higher than that of 0.32(0.21,0.46)in the control group,and the TyG index level of 8.87(8.48,9.22)was also significantly higher than that of 8.26(7.93,8.70)in the control group,with statistically significant differences(all P < 0.05).(2)The RCs of the low-risk,intermediate-risk,and high-risk groups were 0.48(0.33,0.65),0.47(0.34,0.69),and 0.65(0.50,1.02),respectively,with statistically significant differences among the three groups(H=38.317,P<0.05);the TyG indices of the low-risk,intermediate-risk,and high-risk groups were 8.58(8.26,8.93),8.62(8.29,9.01),9.02(8.73,9.46),and the difference was statistically significant when comparing the three groups(H=48.323,P<0.05).(3)The results of Spearman correlation analysis showed that RC was positively correlated with Gensini score(r=0.484,P<0.01)and TyG index was positively correlated with Gensini score(r=0.543,P<0.01).(4)Multiple linear regression analysis showed that RC [B(95% CI)=19.411(7.366-31.456)] and TyG index[B(95% CI)=31.741(22.763-40.718)](both P<0.05)were influential factors for Gensini score after correction for confounders.(5)Multifactorial logistic regression analysis showed that RC,TyG index,and BNP were all independent influencing factors for the occurrence of NSTE-ACS,[OR(95% CI)= 9.375(1.530-57.447),3.977(1.676-9.438),and 1.004(1.000-1.007),respectively,all P < 0.05].(6)The results of the ROC curve showed that RC,TyG index and both combined had diagnostic value for NSTE-ACS,with the area under the curve of 0.796(95% CI: 0.737,0.854),0.795(95% CI: 0.739,0.850),and 0.810(95% CI: 0.759,0.861),respectively.Conclusion:(1)RC and TyG indices may be independent predictors for the diagnosis of NSTE-ACS;(2)RC and TyG indices have significant correlation with Gensini score and are independent predictors of Gensini score.the higher the level of RC and TyG indices,the more severe the severity of coronary artery lesions may be. |
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