Risk Factor Analysis Of CSFP And The Predictive Value Of Framingham Risk Score For CSFP

Objective:The purpose of this study was to investigate the risk factors of coronary slow flow phenomenon and the predictive value of Framingham Risk Score for coronary slow flow phenomenon.Methods:A total of 120 patients with CSFP detected by coronary angiography in Affiliated Hospital of Qingdao University from July 2019 to July 2022 were selected as the CSFP group,and 120 patients with normal or nearly normal coronary angiography were selected as the Non-CSFP group.The general clinical data,blood routine and biochemical indexes of the two groups were compared,and the Framingham Risk Score was calculated.SPSS26.0 and Graph Pad Prism 9 were used for statistical analysis and chart making.The independent risk factors of CSFP were analyzed by Logistic regression model.receiver operating characteristic(ROC)curve was used to calculate the optimal cut-off value and evaluate the diagnostic and predictive value of serum markers and Framingham Risk Score for CSFP.The relationship between serological indexes and coronary frame count and severity of CSFP was analyzed.P≤0.05 was considered to be statistically significant.Results:1.Comparison of general clinical data showed no significant differences in age,gender,BMI,smoking history,hypertension history and diabetes history between the two groups(P > 0.05).2.The comparison of laboratory test indicators showed that the levels of red blood cell count,white blood cell count,neutrophil count,triglyceride,apolipoprotein B and lipoprotein a in CSFP patients were higher than those in Non-CSFP group.P < 0.05,the difference was statistically significant.3.There was no significant difference in Framingham Risk Score between the two groups(P > 0.05).4.Binary Logistic regression model analysis showed that triglyceride level and lipoprotein a level were independent risk factors for CSFP.P < 0.05,the results were statistically significant.ROC curve analysis showed that the area under lipoprotein a curve was 0.776(95%CI 0.718-0.835,P ≤ 0.001,statistically significant),with a cutoff value of250.77mg/L,lipoprotein A predicted the presence of CSFP with a sensitivity of 50.8%and a specificity of 93.3%.The area under the triglyceride curve was 0.606(95%CI 0.535-0.677,P ≤ 0.005,statistically significant),and the area under the Framingham Risk Score curve was 0.496,P > 0.05,with no statistical significance.Lipoprotein a concentration predicted CSFP development more effectively than triglyceride.5.In the CSFP group,102 patients had vascular lesions involving the Left Anterior Descending Artery(LAD)and 76 patients had Right Coronary Artery(RCA).Sixty patients involved in the Left Circumflex Artery(LCX).There were 46 patients with cumulative invasion of 1 blood vessel,30 patients with cumulative invasion of 2 blood vessels,and 44 patients with cumulative invasion of 3 blood vessels.LAD(85%)was the main vessel invaded in patients with CSFP,followed by RCA(63.3%)and LCX(50%).Most of them invaded one blood vessel accumulatively(38.3%).6.Spearman correlation analysis was used to analyze the correlation between Lp(a)concentration and mean coronary frame number,and it was found that the concentration of lipoprotein a was positively correlated with mean coronary frame number,with a correlation coefficient of 0.611(P < 0.001),and the result was statistically significant.The Kruskal-Wallis rank sum test was used to determine differences in lipoprotein a concentrations in patients with different vascular numbers.P≤0.005.The results were statistically significant,indicating that the concentration of lipoprotein a was lower in patients with 1 vessel involvement and higher in patients with 2 or all 3 vessels involvement.Conclusion:1.Lipoprotein a and triglyceride are independent risk factors for CSFP.2.High levels of lipoprotein a are closely related to CSFP.In addition,its concentration increases with the increase of the number of blood vessels involved.Lipoprotein a may be a biochemical indicator to predict the occurrence and severity of CSFP.3.Framingham risk score,as a quantifiable indicator to predict coronary heart disease,cannot play a good role in predicting and diagnosing CSFP.