Correlation Between Platelet Morphological Parameters And Severity Of Coronary Artery Disease And Cardiac Function With Acute Coronary Syndrome

Objective: The purpose of this article is to explore the correlation between platelet morphological parameters and coronary lesion severity(evaluated by calculating Gensini score)and cardiac function in patients with acute coronary syndrome(ACS),to find simple and objective indicators for the severity of coronary lesion in ACS patients,to find high score predictors of Gensini,and to analyze the correlation between platelet morphological parameters and cardiac function in ACS patients,so as to provide certain theoretical basis for the prediction of coronary lesion severity and cardiac function changes in ACS patients.Method:A total of 121 ACS patients hospitalized were admitted to the department of cardiovascular medicine of the second affiliated hospital of University of South China from January 1,2019 to October 31,2019 were selected.In addition,35 patients with normal results(Gensini=0)indicated by selective Coronary angiography(CAG)in ourdepartment due to chest tightness and chest pain were selected as control group.All patiens completed venous blood collection within half an hour after admission,and Platelet distribution width(PDW),Mean platelet volume(MPV),and large platelet large cell ratio(PLCR)were used as evaluation indexes of platelet morphological parameters.All patients completed cardiac color doppler ultrasound within 24 hours after admission,counted left ventricular ejection fraction(LVEF)to evaluate acute cardiac function of ACS patients,completed Coronary angiography(CAG)examination within 24 hours after admission,counted Gensini score,and divided them into low group(1-40 points),medium group(41-80 points)and high group(81 points or more).According to different diagnoses,the participants were divided into UAP/NSTEMI,STEMI and control group,and the relationship between platelet parameters and coronary artery lesions was studied from another side.The data were analyzed by SPSS 24.0,using ?2 test,T test,variance analysis,SNK-q test,Pearson correlation analysis,binary Logistic regression analysis to explore the relationship between platelet morphological parameters and the severity of coronary artery lesions and cardiac function in ACS patients.Results:1.The platelet morphological parameters and other clinical biochemical indexes of ACS group were compared with those of controlgroup: the platelet morphological parameters(PDW,MPV,PLCR)and male ratio,NT-pro BNP,cTnI,CK-MB,UA were all higher than those in the control group,while LVEF in ACS group was lower than that in the control group,and the difference was statistically significant(p<0.05).2.The comparison of platelet morphological parameters and other clinical biochemical indexes between the different Gensini score groups and the control group: the platelet morphological parameters(MPV,PDW,PLCR),LVEF,cTnI,CK-MB,HDL,ALT have significant differences(p<0.05).The MPV,PDW and PLCR in different Gensini scoring groups are higher than those in the control group(p<0.01).MPV,PDW and PLCR are gradually increasing in Gensini low,medium and high scoring groups,and the comparison between any two groups has statistical significance(p<0.01).3.The platelet morphological parameters of different ACS typing groups were compared with the control group: the results showed that the levels of PDW,MPV and PLCR in STEMI group and UAP/NSTEMI group were higher than those in the control group(p<0.01),and the levels of MPV,PDW and PLCR in STEMI group were significantly higher than those in UAP/NSTEMI group(p<0.01).4.Pearson correlation analysis was conducted with Gensini score as dependent variable and platelet morphological parameters and other biochemical indexes as independent variables,and the results showed thatMPV(R2=0.675,p<0.01),PLCR(R2=0.643,p<0.01)were significantly positively correlated with Gensini score.5.Logistic regression analysis showed that PLCR was more correlated with ACS coronary lesions,and PLCR might be a risk factor for coronary Gensini score in ACS patients(OR: 1.243,95%CI:1.088-1.420,p<0.01)6.Pearson correlation analysis was carried out with LVEF as dependent variable,platelet morphological parameters and other clinical biochemical indexes as independent variables,and the results showed that PDW(R2=0.756,p<0.01),PLCR(R2=0.654,p<0.01)were significantly negatively correlated with LVEF.Conclusion:1.Platelet morphological parameters MPV and PLCR are positively correlated with the severity of coronary lesions in ACS patients,and PLCR is more correlated with coronary Gensini score.2.Platelet morphological parameters PDW and PLCR are negatively correlated with LVEF of ACS patients,suggesting that PDW and PLCR reflect cardiac function status of ACS patients to some extent.