Analysis Of The Correlation Between Per And The Degree Of Thrombus Burden In Acute Coronary Syndrome

Objective: To explore the correlation between platelets to eosinophils ratio(PER)and the degree of thrombus burden in patients with acute coronary syndrome.Subjects and methods: A total of 558 patients who were admitted to the First Affiliated Hospital of the University of South China diagnosed with acute coronary syndrome and met the inclusion criteria and exclusion criteria from September 2015 to December 2020 were included in this study.Baseline data,laboratory results and coronary angiography results were collected.According to the TIMI thrombus gade(TTG)score,a total of 377 patients were enrolled in the low thrombus load group(grade0-3)and 181 patients in the high thrombus load group(grade 4-5).Nonparametric test,independent sample t-test and chi-square test were used to compare whether there was statistical difference between the baseline data of the two groups.The correlation coefficients of PER,NLR,HDL-C,CK-MB and the degree of thrombus load were analyzed by linear regression.Binary stepwise Logistic regression was used to analyze the risk factors of the degree of thrombus load in ACS,and ROC curve was used to analyze the efficacy of PER in testing the degree of thrombus load in ACS.Result:1、In the comparison of basic clinical data,there were no statistical differences in gender,age,history of hypertension,history of diabetes,past use of clopidogrel sulfate,ACEI/ARB and statins(p >0.05);The smoking rate in the high thrombus load group was significantly higher than that in the low thrombus load group(67.4% vs 32.1%,p < 0.05).The rates of aspirin and β-blockers in the low thrombus load group were significantly higher than those in the high thrombus load group(18% vs8.2%,p < 0.05;9.4% vs 16.7%,p < 0.05).Among the types of acute coronary syndromes,the prevalence of STEMI in the high thrombus load group was significantly higher than that in the low thrombus load group(72.3% vs 38.7%,p < 0.05),and the prevalence of UA in the high thrombus load group was significantly lower than that in the low thrombus load group(34.7% vs 5.5%,p < 0.05).There was no significant difference in the prevalence of NSTEMI between the two groups(22% vs26.5%,p >0 0.05).2、In the laboratory biochemical and blood routine indexes,the white blood cell count,neutrophil count,low density lipoprotein cholesterol,high density lipoprotein cholesterol,total cholesterol,creatine kinase isoenzyme,NLR,PER in the high thrombus load group were significantly higher than those in the low thrombus load group(p < 0.05).The eosinophil count,mean platelet volume and platelet distribution width in high thrombus load group were significantly lower than those in low thrombus load group(p < 0.05).There was no significant difference in lymphocyte count,platelet,hemoglobin,triglyceride,creatinine and PLR between the two groups.3、In the coronary angiography data,the three-vessel lesion rate of the high thrombus load group was higher than that of the low thrombus load group,and the single-vessel lesion rate of the low thrombus load group was higher than that of the high thrombus load group(p < 0.05).There was no statistically significant difference between the two groups in bilateral vascular disease.The high thrombus load group had a higher incidence of right coronae than the low thrombus load group.There was no significant difference between the two groups in anterior descending and circumflex branches.4、 In the correlation analysis between the degree of thrombus load and NLR,PER,CK-MB and HDL-C,PER(r= 0.579,p < 0.001),NLR(r= 0.38,p < 0.001)and HDL-C(r= 0.1,p =0.01)were all correlated with the degree of thrombus load.CK-MB(r= 0.02,p =0.66)had no significant correlation with the degree of thrombus load.5、In binary stepwise regression analysis,smoking history,CK-MB,PER and NLR were independent risk factors for the degree of thrombus load,and HDL-C was a protective factor for the degree of thrombus load.The ROC curve of PER indicated that the area under the curve was 0.71,and the optimal cut-off value between the two groups was 97.84(sensitivity 51.7%,specificity 78.8%).Conclusion: PER and NLR were correlated with the degree of thrombus load in acute coronary syndrome.PER was more accurate than NLR in evaluating the degree of thrombus load.High PER(>98.74)may be an independent risk factor for high thrombus load.