To Study The Prognostic Value Of Eosinophils In Patients With Acute Myocardial Infarction And The Correlation Of Traditional Chinese Medicine Syndrome Types

Objectives The aim of this study is to analyze the prognostic value of Eosinophils(EOS)in patients with Acute Myocardial Infarction(AMI).Combined with other risk factors,the probability of Major adverse cardiac events(MACE)in patients with AMI was predicted.And the correlation between the related influencing factors of MACE in AMI patients and the traditional Chinese medicine syndrome types of "chest stuffing-heartache" was analyzed,in order to provide more reference for the clinical integration of traditional Chinese and western medicine.Methods A total of 170 Patients with acute myocardial infarction who met the inclusion criteria in Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from December 2020 to March 2022 were enrolled in this study,including 129 males and 41 females.The general information,laboratory examination data and coronary angiography results of the enrolled patients were collected,and they were grou Ped according to the follow-up results.Excel was used to input the data,and SPSS27.0 was used for statistical analysis.The NMACE group was compared with the MACE group,and the count data were analyzed by chi-square test and expressed as [n%].Measurement data following normal distribution were compared by inde Pendent sam Ple t test and expressed as mean ± standard deviation( 2± s).Non-normal distribution and other measurement data were expressed as median(interquartile range)and compared by rank sum test.Univariate Logistic regression analysis and multivariate Logistic regression analysis were used to explore the independent influencing factors of MACE in AMI patients.Receiver operating characteristic(ROC)curve analysis was used to deduce the Youden index,obtain the cut-off value,and obtain the corres Ponding sensitivity,specificity,and the area under the ROC curve to evaluate the prognostic value of the indicators.The EOS levels were grouped according to the best cut-off value,and Kaplan-Meier survival curve analysis was used to compare the survival curves of patients with different EOS levels,and the relationship between EOS levels and the survival time of MACE in AMI patients was clarified.In terms of the correlation between the related influencing factors of MACE in AMI patients and the TCM syndrome types,according to the conformity of the conditions of homogeneity of variance between the groups of each factor,the factors conforming to the conditions of homogeneity of variance were selected by one-way ANOVA test,and the factors not conforming to the conditions of homogeneity of variance were selected by Kruskal-Wallis H test.Results1.A total of 170 patients with AMI were included in this study,and most of them were male and elderly.Most of them were complicated with hypertension,diabetes,dyslipidemia,family history of coronary heart disease,and smoking history.According to the occurrence of MACE within 1 year,48patients(28.2%)had MACE(MACE group)and 122 patients(71.8%)did not have MACE(NMACE group).In terms of age,the median and interquartile range of age in MACE group were significantly higher than those in NMACE group(P = 0.015).There was a high proportion of patients with diabetes in the MACE group,and the difference was statistically significant(P = 0.003).In terms of laboratory indicators,EOS% in MACE group was lower than that in NMACE group,and the difference was statistically significant(P < 0.001).The level of CRP in MACE group was higher than that in NMACE group(P= 0.011).The level of c Tn I in MACE group was significantly higher than that in NMACE group(P < 0.001).2.Univariate binary Logistic regression analysis showed that age(OR:1.045,95%CI: 1.006-1.085,P = 0.024),diabetes(OR:0.354,95%CI:0.176-0.714,P = 0.004),EOS%(OR:0.545,95%CI: 0.383-0.775,P = 0.001),CRP(OR:1.236,95%CI: 1.094-1.396,P = 0.001),c Tn I(OR:1.010,95%CI:1.005-1.015,P = 0.001),P< 0.001)and BNP(OR:1.006,95%CI: 1.002-1.010,P = 0.002)were correlated with the occurrence of endpoint events.Multivariate binary Logistic regression analysis was used to analyze the independent correlation between age,diabetes,EOS%,CRP,c Tn I and BNP and the endpoint events.The results showed that c Tn I(OR:1.006,95%CI:1.001-1.011,P = 0.019),EOS%(OR:0.692,95%CI: 0.492-0.972,P = 0.034)and CRP(OR:1.235,95%CI: 1.078-1.414,P = 0.002)were independent influencing factors for the occurrence of endpoint events.The ROC analysis of c Tn I and EOS% showed that the AUC value of EOS% was 0.777,the specificity was 0.820,and the sensitivity was 0.729.The AUC value of c Tn I was 0.817,the specificity was 0.656,and the sensitivity was 0.958.3.The EOS% level of AMI patients was grouped according to the best cut-off value,and Ka Plan-Meier survival function curve analysis showed that the survival curve of patients in the high EOS% level group was higher than that in the low EOS% level group.The overall comparison of the survival curve between the two groups was analyzed by Log Rank test: there was a very significant difference in the long-term and short-term MACE of AMI patients between the high EOS% level group and the low EOS% level group(P < 0.001).4.The distribution of TCM syndromes types in patients with AMI is mainly phlegm and blood stasis syndrome,qi deficiency and blood stasis syndrome,qi stagnation and blood stasis syndrome,qi Yin deficiency syndrome,and Zheng deficiency and Yang removal syndrome.Compared with NMACE group,the proportion of the syndrome of mutual accumulation of phleitm and blood stasis,the syndrome of deficiency of qi and Yin,and the syndrome of deficiency of qi and Yin in MACE group were higher,and the differences were statistically significant(all P < 0.05).5.Analysis of the influencing factors of MACE in AMI patients and TCM syndrome types: EOS% level: Zheng-deficiency Yang decolulation syndrome < qi stagnation and blood stasis syndrome,phand stasis mutual accumulation syndrome(adjusted P = 0.038,P = 0.042);c Tn I level: positive deficiency Yang syndrome > qi deficiency and blood stasis syndrome,phlegm and blood stasis syndrome,qi stagnation and blood stasis syndrome(adjusted P = 0.001,P = 0.001,P = 0.006);At the age level,qi deficiency and blood stasis syndrome > qi stagnation and blood stasis syndrome > both qi and Yin deficiency syndrome > positive deficiency and Yang removal syndrome >mutual combination of phlegm and blood stasis syndrome.Among them,there were statistically significant differences in the age level between the two groups of qi stagnation and blood stasis syndrome,qi stagnation and blood stasis syndrome,and qi deficiency and blood stasis syndrome(P < 0.05).There was statistically significant difference in age between Zheng-deficiency Yang syndrome and Qi-deficiency and blood-stasis syndrome(P = 0.042).In the analysis of diabetes and TCM syndrome types,the syndrome types of AMI patients complicated with diabetes were more common in Zheng-deficiency Yang syndrome and qi-Yin deficiency syndrome.The proportion of patients complicated with diabetes in TCM syndrome types was compared: Zheng-deficiency Yang syndrome > mutual accumulation of phlegm and blood stasis syndrome,Qi-stagnation and blood-stasis syndrome,Qi-deficiency and blood-stasis syndrome(all P < 0.05);qi-yin deficiency syndrome > mutual accumulation of phlegm and blood stasis syndrome,qi-deficiency and blood-stasis syndrome(all P < 0.05).6.The number of coronary vessels involved in AMI patients is mainly multi-vessel disease,and the offending vessels are mainly LAD and RCA.Comparison of TCM syndrome types and the number of involved branches of coronary artery disease: three-vessel lesions were more common in the syndrome of mutual accumulation of phlegm and blood stasis,qi deficiency and blood stasis,double-vessel lesions were more common in the syndrome of mutual accumulation of phlegm and blood stasis,qi stagnation and blood stasis,but there was no statistical significance(P > 0.05).Conclusion1.AMI patients are characterized by older age and a higher proportion of males.Compared with patients without MACE,patients with MACE are older and have a higher proportion of diabetes mellitus.2.EOS% level has a predictive effect on the prognosis of AMI patients,and the lower the EOS% level,the higher the risk of MACE.3.The distribution of TCM syndromes types in AMI patients is mostly phlegm and blood stasis syndrome,qi deficiency and blood stasis syndrome.In the MACE group,the proportion of patients with the syndrome of mutual accumulation of phsputum and blood stasis,the syndrome of deficiency of positive Yang,and the syndrome of deficiency of both qi and Yin was high.The objective indicators and risk factors EOS%,c Tn I,diabetes,and age were correlated with the TCM syndrome type.Low EOS% and high c Tn I were more common in Zhengyang deficiency syndrome.Patients with diabetes mellitus are mostly characterized by deficiency of both qi and Yin.The elderly patients mostly presented with qi deficiency and blood stasis syndrome.