To Explore The Correlation Between Chest CT,Coronary Angiography Results And The Distribution Of Traditional Chinese Medicine Syndrome Types Of Coronary Heart Disease Based On Data Mining

Purpose:1.To explore the correlation between traditional Chinese medicine(TCM)syndrome type,risk factors and coronary angiography results in patients with coronary heart disease(CHD),in order to provide objective basis for TCM syndrome differentiation.2.To explore the synchronous relationship between coronary artery calcification(CAC)detected by chest CT and coronary angiography(CAG)and its influencing factors,so as to provide suppor in CHD diagnosis by chest CT.Methods:In all,385 hospitalized patients diagnosed with CHD by CAG in the Affiliated Hospital of Jiangxi University of TCM from January 2020 to October 2022 were enrolled in this study.Collecting patient’s name,gender,history of smoking,history of obesity and overweight,age,complications,four of blood lipids,CAG,chest CT,four diagnosis and other information,according to the four diagnosis information and the quantitative scoring standard of TCM syndrome type,the syndrome differentiation was conducted by two deputy chief Chinese medicine doctors.To describe the clinical characteristics of patients with CHD,the differences among diverse TCM syndrome types and chest CT and CAG were compared between synchronous and non-synchronous groups.Results:1.TCM syndrome type distribution: Syndrome of phlegm turbid obstruction110 cases 、 Syndrome of qi deficiency and blood stasis 88 cases 、Syndrome of heart-blood stasis 60 cases、Syndrome of qi-Yin deficiency 49 cases、Syndrome of qi stagnation and blood stasis 45 cases 、Syndrome of heart-kidney Yang deficiency 15cases、Syndrome of heart-kidney Yin deficiency 13 cases、Syndrome of heart-pulse coagulation 5 cases.2.Comparison of TCM syndrome types in every group:(1)Gender: There were 234 males and 151 females with CHD.there was no statistical difference in the gender of each TCM syndrome types.(2)Age: The age of patients with CHD ranged from 33 years old to 88 years old,with an average age of67.05±10.46 years old,there were statistical differences in the age of each TCM syndrome types,and the Syndrome of Qi deficiency and blood stasis was the oldest;There was no statistical difference in the age distribution of each TCM syndrome types.(3)Smoking history: 166 patients with CHD had smoking history,there was no statistical difference in the smoking history of each TCM syndrome types.(4)History of obesity and overweight: 127 patients with CHD had a history of obesity and overweight,there were statistical differences in the obesity and overweight history among the TCM syndrome,Syndrome of phlegm turbid obstruction had more obesity and overweight history than other syndrome types.(5)Complications: There were 323 cases of hypertension,118 cases of type 2 diabetes,224 cases of dyslipidemia.there was no statistical difference in the complications of each TCM syndrome types.(6)Four items of blood lipid: there was no statistical difference in the levels of TC and TG among the TCM syndrome types;There were statistical differences in the levels of HDL-C and LDL-C among all groups.The level of HDL-C was the lowest and the level of LDL-C was the highest in Syndrome of phlegm turbid obstruction syndrome.(7)Coronary angiography: There was no statistical difference in the degree of coronary artery stenosis among each TCM syndrome types.there were statistical differences in the number of coronary lesions and Gensini scores in each group.Syndrome of phlegm turbid obstruction,Syndrome of qi deficiency and blood stasis,Syndrome of heart-blood stasis are mainly coronary multi-vessel lesions.Syndrome of qi-Yin deficiency,Syndrome of qi stagnation and blood stasis,Syndrome of heart-kidney Yang deficiency mainly consist of single coronary artery disease.The Gensini scores of Syndrome of phlegm turbid obstruction,Syndrome of qi deficiency and Syndrome of heart-blood stasis were higher than Syndrome of qi stagnation and blood stasis and Qi Yin deficiency syndrome.(8)Chest CT:There were statistical differences in chest CT calcification and Agatston score among all syndrome groups,Qi deficiency and blood stasis syndrome,phlegm turbidity-obstruction syndrome in the majority of patients,Agatston scores were higher than Other syndromes.3.General information: among the 385 patients with CHD,88 years old was the oldest,33 years old was the youngest,and 67.05±10.46 years old was the average age.There were 234 males(60.8%)and 151 females(39.2%).166 cases(43.1%)had history of smoking.127 cases(33.0%)had history of obesity and overweight.323cases(83.9%)with hypertension.118 cases(30.6%)had type 2 diabetes mellitus.There were 224 cases(58.2%)with dyslipidemia.Only 18 patients(4.7%)had no three major comorbidities.4.Coronary artery calcification of chest CT: among the 385 patients with CHD,227 patients were found to have at least one coronary artery calcification on chest CT scan,with a calcification rate of 59.0%,and the calcification rate of left anterior descending artery was the highest.The results of coronary angiography confirmed that 200 patients had stenosis ≥50% in the calcified coronary artery,and the remaining27 patients had no obvious stenosis in the calcified coronary artery.The sensitivity was 88.1%,and the sensitivity of left anterior descending artery was the highest.The overall positive detection rate of CAC on chest CT was 51.9%,and the positive detection rate of moderate and multiple coronary artery stenosis was higher.5.Comparison of the two kinds of tests between the synchronous group and the non-synchronous group:(1)There were statistically significant differences between the synchronous group and the non-synchronous group in gender,age,history of smoking,history of obesity and overweight,complications,age;There was no statistical difference in blood lipid.(2)There were statistical differences in Gensini score,amount of coronary artery lesions and degree of coronary artery lesions between the two groups.The Gensini score in the synchronous group was significantly higher than that in the non-synchronous group,and the coronary artery lesions in the synchronous group were mainly double and multi-vessel,and the majority were moderate stenosis.(3)In synchro group,qi deficiency and blood stasis syndrome and phlegm turbidity-obstruction syndrome were dominant.Conclusions:1.Most patients with coronary heart disease develop at the age of 50-79 and show a younger trend,with more males than females.Patients with a history of smoking,obesity and overweight account for a large proportion,and the vast majority of patients are complicated with hypertension,dyslipidemia and type 2 diabetes.2.TCM syndrome types may be related to patients’ age,history of obesity and overweight,HDL-C level,LDL-C level,number of coronary artery lesions,Gensini score,and Coronary artery calcification or not.3.The TCM syndrome types of chest CT and coronary angiography were mainly qi deficiency and blood stasis syndrome and phlegm-turbidity-obstruction syndrome.4.Chest CT found positive coronary calcification,Syndrome is Qi deficiency and blood stasis or phlegm-turbidity-obstruction syndrome,male smoking obese patients with multiple complications,The incidence of positive coronary angiography is higher,and the likelihood of severe coronary lesions is greater.