The Relationship Between Epicardial Adipose Tissue And Clinical Prognosis Of Coronary Heart Disease For Patients With Percutaneous Coronary Intervention

Objective To observe the major advers cardiovascular events(MACE) whthin 1 year of patients with coronary heart disease(CHD) after percutaneous coronary intervention(PCI).Probing into the relationship between the volume of epicardial adipose tissue(EAT)with the prognosis of patients with coronary heart disease afer PCI.To further evaluate EAT’s clinical value in the pathogenesis and prognosis of coronary heart disease.In order to provide a new target for prognosis of patients after PCI.Methods A total of 237 patients diagnosed CHD and PCI was performed in XXX Hospital between December 2013 and November 2014 were followde up.Measuring the epicadial adipose tissue voluem by multi-sclice CT(MSCT).According the result of EATV,patients were divided into three groups,A group(EATV≦75cm3),B(75cm3<EATV<150cm3), and C group(EATV≧150cm3).Then test the level of blood lipids, blood glucose,interleukin(IL)-6,tumor necrosis factor(TNF)-α,hypersenstive c-reactive protein(hs-CRP)and adiponectin of the three groups.Arranging perform Coronary Angiography(CAG) and PCI. Analyze the relationship between EATV with inflammatory cytokines and risk fators of coronary heart disease in the three groups which were followed for 1 year of MACE,exploring the influence of EATV to the rate of MACE events of patients who were performed PCI.Results Comparing the general data of the three groups,their was no stastistical difference between the three groups in age 、gender、hypertention、diabetes、the level of LDL、HDL、TC and TG(p< 0.05). However,when compared BMI、the level of Hs-CRP、IL-6、TNF-α、they found group B was higher than group A, group C was significantly higher than group A、B,they had stastistical difference within the three groups(p< 0.01 or p< 0.05). But, when compared the level of adiponectin :group A was significantly higher than group B、C, group B was higher than group C, the difference was statistically significant(p < 0.01). Then do Spearman correlation analysis with EATV: hs-CRP、The volume of EAT was positively correlated with CRP,IL-6,TNF-α,(r=0.675~0.700, p<0.01),and negatively correlated with adiponectin.(r=-0.629, p<0.01). However,it had a weak positive correlation with BMI(r=0.410, p<0.01). In this study,the number of MACE in the three groups were recorded, group C was the highest, group A was the lowest. They had significant statistical significance(p < 0.01). Then do ROC curve, result: the prognostic criteria for EATV level was 116.11cm3 determined by ROC(area under cure :0.779(95%CI:0.669~0.889, p<0.01), the sensitivity was 86.4%,the specificity was 60%, so,it had a better predictive value.Finally, doing line logistic analysis between MACE events and common risk factors of coronary heart disease : EATV >116.11cm3(OR=4.584, p<0.05), multiple lesions(OR=3.416, p<0.05) and non entirely reascularization(OR=1.103, p<0.05)were independent risk factors for MACE events after PCI.Conclusion EAT can secrete amounts of CRP,IL-6 and TNF-α,all of this factors can restrin the secretion of adiponectin.The level of EATV was closely related to the incidence of MACE events in patients after PCI, EATV>116.11cm3,multiple lesions and non entirely reascularization were independent risk factors for MACE in patients afer PCI within one year, they can be used to evaluate and predict the prognosis of PCI in patients with coronary heart diseases.so it not only is popular in the study,but also provides a new target for therapy of heart disease in the future.