Correlation Between Cerebral-Cardiac Syndrome In Patients With Large Artery Atherosclerotic Cerebral Infarction And Carotid Plaque Stability

Objectives:To explore the correlation between cerebral-cardiac syndrome in patients with large artery atherosclerotic cerebral infarction and carotid plaque stability,and to further study the relationship between cerebral-cardiac syndrome and atherosclerosis,so as to provide a basis for the diagnosis and treatment of cerebral-cardiac syndrome.Methods:A total of 229 patients with large artery atherosclerotic cerebral infarction who were hospitalized in the Department of Neurology,the First Affiliated Hospital of Dali University from September 2020 to August 2022 were selected as the subjects.The subjects were divided into cerebral-cardiac syndrome group and non-cerebral-cardiac syndrome group according to whether they had cerebral-cardiac syndrome or not.The general clinical data,laboratory indicators,and carotid duplex ultrasound data of the two groups were collected.T-test,rank sum test,chi-square test and Logistic regression were used to analyze the influencing factors of cerebral-cardiac syndrome,and ROC curve was used to analyze the predictive value of carotid plaque for cerebral-cardiac syndrome.Results:1.Among 229 patients with large artery atherosclerotic cerebral infarction,137 cases were in cerebral-cardiac syndrome group,and the incidence of cerebral-cardiac syndrome was 59.83%.2.There were significant differences in age(t=-3.587,P<0.001)and NIHSS score(X2=3.931,P=0.047)between the two groups.3.There were statistical differences in homocysteine(Z=-2.514,P=0.012),C-reactive protein(Z=-2.032,P=0.042),fibrinogen(Z=-2.164,P=0.030)and D-dimer(Z=-2.613,P=0.009)between the two groups.4.There were significant differences between the two groups in the presence or absence of carotid plaque(X2=7.790,P=0.005),the number of carotid plaque(X2=5.781,P=0.016),and the carotid plaque stability(X2=19.938,P<0.001).5.Binary Logistic regression analysis showed that moderate to severe NIHSS score(OR=2.008,95%CI=1.080-3.733,P=0.028),carotid plaque(OR=4.620,95%CI=1.827-11.68,P=0.001)and carotid unstable plaque(OR=0.242,95%CI=0.121-0.482,P<0.001)were independent risk factors for cerebral-cardiac syndrome in patients with large artery atherosclerotic cerebral infarction.6.The area under the ROC curve of carotid plaque stability for predicting cerebral-cardiac syndrome in patients with large artery atherosclerotic cerebral infarction was 0.683.When the cut-off value was unstable plaque,the prediction efficiency was the highest,the sensitivity was 56.9%,and the specificity was 77.2%(P<0.001).Conclusions:1.Cerebral-cardiac syndrome is often associated with large artery atherosclerotic cerebral infarction,and the incidence is high.2.Age,NIHSS score,homocysteine,C-reactive protein,fibrinogen,D-dimer,carotid plaque,the number of carotid plaque,and carotid plaque stability were the influencing factors for cerebral-cardiac syndrome in patients with large artery atherosclerotic cerebral infarction.Among them,moderate to severe NIHSS score,carotid plaque,and carotid unstable plaque were independent risk factors for cerebral-cardiac syndrome in patients with large artery atherosclerotic cerebral infarction.3.Carotid plaque stability has a certain predictive value for cerebral-cardiac syndrome in patients with large artery atherosclerotic cerebral infarction.