Study On Correlation Between Traditional Chinese Medicine Syndromes And Percutaneous Coronary Intervention Postoperative Major Adverse Cardiac Events

Percutaneous coronary intervention(PCI)is one of the main methods to treat coronary heart disease(CHD),which has great advantages of improving symptoms and reducing short-term mortality.Major adverse cardiac event(MACE)is an important complication after PCI,which strongly affects long-term prognosis of patients and increases the economic burden of patients.MACE is a complex cardiovascular issue,which consists of sudden cardiac death,recurrent Nonfatal Myocardial Infarctionnon fatal non-fatal myocardial infarction,unstable angina,subacute stent thrombosis,and target vessel revascularization.MACE after PCI belongs to the category of "thoracic obstruction" in traditional Chinese medicine.Traditional Chinese medicine has some unique advantages of thoracic obstruction treatment.There are many researches on prevention of postoperative restenosis in traditional Chinese medicine,whereas little attention is paid to TCM Syndromes of MACE after PCI and the clinical guidance is limited.Therefore,from the above,this study of exploring the correlation between MACE and TCM syndromes after PCI has a certainly practical significance.Objective:to investigate the risk factors and TCM syndrome characteristics of MACE after PCI and provide theoretical basis for TCM dialectical treatmentMethods:we reviewed the data of coronary heart disease patients who received PCI in the cardiac intervention center of our hospital from January 2014 to June 2019 and recruited subjects meeting the inclusion criteria.According to whether MACE occurred after PCI,the patients were divided into the case group(MACE occurred)and the control group(no MACE occurred).The characteristics of clinical high-risk population of MACE patients after PCI and the correlation between MACE and TCM syndrome were studied by utilizing retrospective analysis.Results:1686 cases were included in this study.The average age of the patients is 64.12±12.47 years old,including 1170 males and 516 females.Clinical diagnosis:258 cases of stable angina pectoris,710 cases of unstable angina,316 cases of non ST elevation myocardial infarction and 402 cases of ST elevation myocardial infarction.The overall distribution of TCM syndromes:647 cases of qi deficiency and blood stasis syndrome,239 cases of phlegm stasis syndrome,218 cases of heart blood stasis syndrome,194 cases of Qi and blood deficiency syndrome,192 cases of qi stagnation and blood stasis syndrome,82 cases of Yang Qi deficiency and decline syndrome,62 cases of cold coagulation and blood stasis syndrome and 52 cases of heart kidney yin deficiency syndrome.Among the 1686 patients,158 had MACE and 1528 had no MACE.There is statistical significance on the differences between the two groups in heart rate,western medicine diagnosis,Killip classification,previous history of type 2 diabetes mellitus,chronic kidney disease,ST segment depression of ECG,LVEF value,blood creatinine,creatinine clearance rate,pathological vessel left main trunk,total number of stents,number of stents,classification and application of temporary pacemaker,total score of grace and total score of grace(P<0.05).TCM syndrome distribution of 158 patients with MACE after PCI:80 cases of qi deficiency and blood stasis syndrome,26 cases of cold coagulation and blood stasis syndrome,12 cases of phlegm stasis syndrome,11 cases of Qi and blood deficiency syndrome,9 cases of heart blood stasis syndrome,8 cases of qi stagnation and blood stasis syndrome,7 cases of Yang Qi deficiency and decline syndrome and 5 cases of heart kidney yin deficiency syndrome.Compared with the patients who did not have MACE,the proportion of qi deficiency and blood stasis syndrome and cold coagulation and blood stasis syndrome was higher in the patients with MACE,and the difference between the groups was statistically significant(P<0.05).Univariate logistic regression analysisSingle factor Logistic regression analysis showed that(?=0.10)previous history of type 2 diabetes,chronic kidney disease,ECG ST segment depression,diseased blood vessel left main body,application of temporary pacemaker,western medicine diagnosis of unstable angina,ST segment elevation myocardial infarction,TCM syndrome heart blood stasis,Qi deficiency and blood stasis,phlegm and blood stasis,cold coagulation and blood stasis,qi stagnation and blood stasis,Killip classification-Grade 3,more than 5 stents,grace 3 Classification and high risk had statistical significance(P<0.05).The index of P<0.10 in the univariate logistic regression analysissingle factor Logistic analysis results was included in the multivariate logistic analysis multi factor Logistic analysis.It was found that the previous history of type 2 diabetes mellitus(odds ratio=1.442,95%confidence interval:1.007?2.067),chronic kidney disease(odds ratio=2.100,95%confidence interval:1.234?3.576),the application of temporary pacemaker(odds ratio=6.311,95%confidence interval:2.996?13.295),and the number of implanted stents>5(odds ratio=2.431,95%confidence interval:1.434?4.121),grace total score-"high risk"(odds ratio=2.438,95%confidence interval:1.482?4.012),TCM syndrome-qi deficiency and blood stasis syndrome(odds ratio=2.805,95%confidence interval:1.919?4.099),cold coagulation and blood stasis syndrome(odds ratio=12.320,95%confidence interval:6.652?22.818),which mean the risk of MACE increased after PCI Factors(P<0.05).Conclusion:Qi deficiency and blood stasis syndrome,cold coagulation and blood stasis syndrome are relate to MACE after PCI;Qi deficiency and blood stasis syndrome,cold coagulation and blood stasis syndrome are the risk factors of MACE after PCI,which are the same as the previous type 2 diabetes,the previous chronic kidney disease,the application of temporary pacemaker,the number of implanted stents>5 and the high risk of grace score.