Correlation Between SHR,NLR And Severity Of Acute Coronary Syndrome Lesions

Objective:In this study,the stress hyperglycemia ratio(SHR)and neutrophil/lymphocyte ratio(NLR)were calculated through experimental indicators that were routinely tested and easily obtained,such as blood glucose,glycosylated hemoglobin,absolute neutrophil number,and absolute lymphocyte number at admission,and the correlation between SHR,NLR and acute coronary syndrome(ACS)lesion severity,so as to make a preliminary judgment on the priority of the disease and treat it accordingly to prevent further progression of the disease.Methods:A retrospective analysis of 115 patients diagnosed with ACS and undergoing coronary angiography(CAG)in the Second Clinical Hospital of Shanxi Medical University from January 1,2022 to December 31,2022 was retrospectively collected.According to the results of CAG of patients,they were divided into single-vessel ACS group and multi-vessel ACS group;According to the stress hyperglycemia ratio(SHR),it was divided into three groups: T1 group(SHR<0.762),T2 group(0.762≤SHR<1.040),T3SHR≥1.040;according to the neutrophil/lymphocyte ratio(NLR),it was divided into three groups: A1 group(NLR<1.872),group A2(1.872≤NLR <2.985),A3 group(NLR≥2.985).The collected data were analyzed by collecting basic data of the study subjects,laboratory test results,CAG and echocardiography related parameters,and the collected data were analyzed by SPSS26.0,and the continuous variables were expressed as mean ±standard deviation((?)±SD)or median(M)and interquartile range(IQR),and categorical variables were expressed as numbers and percentages.The chi-square2 test was used for categorical variables and the t-test,ANOVA,and the Mann-Whitney U or Kruskal-Wallis H test was used for continuous variable comparisons.Logistic regression and subject operating characteristics(ROCs)were used to analyze associations between SHR,NLR,and ACS severity.The area under the curve(AUC)was used to evaluate the sensitivity and specificity of SHR and NLR in evaluating coronary disease severity.Results:1.A total of 115 patients were included in this study,with an average age of61.77±9.95.Male patients accounted for the majority(74.8%),and single and multi-vessel lesions accounted for 34.80% and 65.20%,respectively.2.Smoking,diabetes history,LDL-C,HDL-C,LVEF,SHR and NLR were statistically significant in the single ACS and multivascular ACS groups(P<0.05);There were significant differences in blood glucose on admission,HDL-C,LVEF,multivascular ACS,and T1,T2 and T3 groups(P<0.05).Age,BNP,BUN,IVS,and multivascular ACS were statistically significant in the A1,A2,and A3 groups(P<0.05).3.Multivascular ACS was used as the dependent variable,and univariate logistic regression was used to analyze the relationship between ACS severity and risk factors.The results showed that smoking,diabetes history,LDL-C,SHR and NLR were positively correlated with multivascular ACS(P<0.05),and HDL-C and LVEF were negatively correlated with multivascular ACS(P<0.05).4.logistic regression was used to analyze the relationship between SHR and ACS severity,and the results showed that the risk of multi-vessel ACS in the T2 group was6.068 times that in the T1 group after adjustment and confounding(95%CI: 1.606-22.927,P=0.008),and the risk of multi-vessel ACS in T3 group was 3.498 times that in T1 group(95%CI: 1.034-11.834,P=0.044).The AUC of SHR was 0.689(95%CI: 0.5855-0.794).5.logistic regression was used to analyze the relationship between NLR and ACS severity,and the results showed that after adjusting for confounding factors,the risk of multi-vessel ACS was 3.959 times higher in group A2 than in group A1(95%CI:1.088-14.400,P=0.037).The risk of multi-vessel ACS was 7.881 times greater in the A3 group than in the A1 group(95%CI: 2.003-31.003,P=0.003).The AUC for SHR was 0.689(95%CI: 0.5855-0.794).Conclusion:1.SHR and NLR are positively correlated with the severity of ACS.With the increase of SHR and NLR levels,the degree of ACS lesions also increases.2.SHR and NLR are independent risk factors for the occurrence of multivascular ACS,and have certain diagnostic value for the occurrence of multivasculars ACS.