A Comparative Study Of Multiple Non-invasive Measurements On Vascular Lesions To Estimate The Acute Coronary Syndrome

Objective and Background:With the improvement of people's living standard, the change of living habits and food structure, the aging of the population, the morbidity of coronary heart disease (CHD) show a tendency to rise year by year. It has already become an important public health problem of current society, because acute coronary syndrome (ACS)has the clinical features of urgent onset and high mortality. And the arteriosclerosis plays an important role in the onset of ACS.ACS harms people's health seriously. It is of great significance to early diagnosis, prediction of high risk patients, guiding for prevention and treatment. So we are trying to evaluate some non-invasive measurements in diagnosis of ACS.Methods:There were 171 continuous subjects who were considered as high risk patients and did cardiac physical examination in Tianjin medical university general hospital geriatric department from Jan,2007 to Dec,2008.Finally, there were 102 who were conformity with the protocol and entered the study.These subjects were divided into acute coronary syndrome (ACS) group (n=52) and control group (n=50). All subjects received MSCT scan, carotid artery ultrasound, arteriosclerostic test and blood biochemical markers exam, observing CACS,IMT, baPWV,TC, TG, LDL, HDL, etc. The data are analyzed by Wilcoxon test, t-test, chi square test, with SPSS software version 13.0. A value of P<0.05 was considered significant in double-sided tests.Results:(1)Age and the prevalence of hypertension, DM and hyperlipidemia are significantly higher in ACS group than in control group, and it has significant difference between them(P<0.05).(2)The CACS,Mass and Volume are higher in ACS group than in high risk group(P<0.001).The ratio of people in ACS group increases by increased risk. There was significant differences(P<0.001).(3)The prevalence of coronary arterial calcified plaques is higher in ACS group subjects than in high risk group(P<0.001).(4)The calcified plaques in coronaries are more usual in LAD,and then in RCA, rare in LCX and LMA. (5)The left IMT, right IMT, the greater value of both sides and the prevalence of plaque are higher in ACS group than in high risk group, and left IMT is higher than right IMT in two groups. The difference has no statistic significance in right IMT(P>0.05).There are significant differences of left IMT, the greater value of both sides and prevalence of plaque in two groups (P<0.05).(6)The prevalence of carotid arterial arteriosclerosis is significantly higher in ACS than in high risk group (P<0.001).(7)After semiquantitative scores of carotid arterial plaque, the ratio of high risk group is higher than the one of ACS in score=0 and 1.In score> 2, the ratio of ACS is higher than it of high risk group.(8)The values of left baPWV,right baPWV, and the greater value of both side baPWV are higher in ACS group than control group(P<0.05)(9)The prevalence of peripheral arteriosclerosis is significantly higher in ACS group than control group (P<0.001).(10)All subjects were divided into 4 groups by quartile of baPWV.The number of people in high risk group is less and less, the ratio decreased, by increasing of baPWV, and the number of people in ACS group increases.Conclusion:Peripheral atherosclerosis and coronary atherosclerosis have same pathological basis, pathogenesis and risk factors.Peripheral arterial changes reflect coronary disease directly. It is noninvasive, easier and repeatable to exam the atherosclerosis in peripheral arteries, so these methods can be used widely in high risk people early screening and monitoring.