Correlation Analysis Of Microcirculation Disorder And Prognosis And Risk Factors In ACS Patients With Phlegm Turbidity And Blood Stasis After PCI

Purpose:To investigate the risk factors and prognosis of coronary microvascular dysfunction after percutaneous coronary intervention(PCI)in patients with phlegm and blood stasis of acute coronary syndrome(ACS).Material and method:The study selected 86 patients with phlegm and blood stasis of acute coronary syndrome,and they underwent PCI in the Liaoning University of Traditional Chinese Medicine from March 2017 to September 2019.after PCI(24 hours later,within 7days),they were assessed using myocardial contrast echocardiography(MCE)and echocardiography,according to the MCE results,they were divided into two groups:microvascular dysfunction group(MD,n = 41)and no microvascular dysfunction group(NMD,n = 45).The patient's clinical data,such as age,gender,BMI,diabetes,hypertension,etc.,were collected to explore their association with microvascular dysfunction after PCI in patients with phlegm and blood stasis of ACS.Echocardiography was performed 3 months after PCI and the results were compared with the one earlier.Patients were followed up at 3months after PCI(major adverse cardiac events: cardiovascular death,myocardial infarction,stroke;secondary events: hospitalization for heart failure,arrhythmia requiring hospitalization/ICD implantation,reperfusion therapy,angina pectoris)and compare the difference between the two groups.Results:1.diabetes(P=0.03,OR=5.31,95%CI:1.19-23.79)and/or an elevated concentration of CTnI(P=0.003,OR=1.03,95%CI:1.01-1.05)are associated with microvascular dysfunction after PCI in patients with phlegm and blood stasis of ACS.2.based on assay results of echocardiography,the LVESV of the NMD group was lower than that of the MD group,and the LVEF was higher than the MD group(P<0.05).Compared with the results of echocardiography which was performed from 24 hours to 7 days after PCI,the LVEDD,LAD,and LVEDV were significantly increased in both two groups compared with the results of 3 months after PCI(P < 0.05),but there were no differences in the extent ofthose indicators above between those two groups(P=0.17,P=0.72,P=0.53).Compared with the results of echocardiography completed in 3 months after PCI,the LVESV and LVEF of the two groups were not significantly changed(P>0.05).3.No MACEs occurred in the two groups within three months,but the overall incidence of adverse events was significantly higher in the MD group(P=0.03).Conclusion:1.Patients with turbid bloody ACS who have diabetes or an elevated concentration of CTnI are more likely to have microvascular dysfunction after PCI.2.Microvascular dysfunction had no significant effect on the change of echocardiography indexes,such as LVEDD,LAD,LVESV,LVEDV,LVEF,in patients with phlegm and blood stasis of ACS after PCI.3.Patients with phlegm and blood stasis of ACS with microvascular dysfunction after PCI have a poor short-term clinical prognosis.