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单核细胞计数对稳定型冠状动脉疾病患者中显著冠状动脉疾病识别的预测作用。

Predictive role of monocyte count for significant coronary artery disease identification in patients with stable coronary artery disease.

机构信息

Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland.

Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Cardiol J. 2024;31(5):722-730. doi: 10.5603/cj.95131. Epub 2023 Dec 27.

Abstract

BACKGROUND

The coronary artery disease (CAD) remains the leading cause of morbidity that is characterized by broad spectrum of symptoms. Up to 30% of performed angiographies reveal normal coronary arteries. The aim of the study was to find simple predictor for significant epicardial artery stenosis among patients with chronic coronary syndrome.

METHODS

There were 187 patients (131 (709%) men and 56 (30%) women) in the median (Q1-Q3) age of 67 [58-72] presenting with stable CAD symptoms enrolled into the present retrospective analysis. The demographical, clinical and laboratory characteristics between patients with normal and significant coronary artery stenosis were compared.

RESULTS

The multivariable analysis revealed coexistence of hypercholesterolemia as significant differentiation factor (odds ratio [OR]: 4.38, 95% confidence interval [CI]: 1.78-10.80, p = 0.001) for significant CAD and inverse relation to serum high density lipoprotein (OR: 0.19, 95% CI: 0.05-0.72, p = 0.015) and relation to creatinine concentration (OR: 1.03, 95% CI: 1.00-1.05, p = 0.012). Among whole peripheral blood count analysis, the significant relation was noticed to be hemoglobin concentration (OR: 1.09, 95% CI: 1.10-1.18, p = 0.022) and monocyte count (OR: 32.3, 95% CI: 1.09-653.6, p = 0.017). Receiver operator curve revealed (AUC: 0.641, p = 0.001) with the optimal cut-off value above 0.45 K/uL for monocyte, yelding sensitivity of 81.82% and specificity of 58.06%.

CONCLUSIONS

The peripheral monocyte count above 0.45 k/uL may be considered as a predictor of significant coronary artery disease in symptomatic patients with chronic coronary syndrome.

摘要

背景

冠心病(CAD)仍然是发病率最高的疾病,其特征是症状谱广泛。多达 30%的血管造影显示正常冠状动脉。本研究旨在寻找慢性冠状动脉综合征患者中存在显著心外膜动脉狭窄的简单预测因子。

方法

本研究共纳入 187 名患者(男 131 例[709%],女 56 例[30%]),中位(Q1-Q3)年龄 67 [58-72] 岁,有稳定型 CAD 症状,回顾性分析这些患者的临床资料。比较冠状动脉狭窄正常和显著患者的人口统计学、临床和实验室特征。

结果

多变量分析显示,高胆固醇血症共存是显著 CAD 的显著分化因素(比值比[OR]:4.38,95%置信区间[CI]:1.78-10.80,p=0.001),与血清高密度脂蛋白呈反比(OR:0.19,95%CI:0.05-0.72,p=0.015),与肌酐浓度呈正相关(OR:1.03,95%CI:1.00-1.05,p=0.012)。在全血计数分析中,血红蛋白浓度(OR:1.09,95%CI:1.10-1.18,p=0.022)和单核细胞计数(OR:32.3,95%CI:1.09-653.6,p=0.017)呈显著相关。接受者操作特征曲线(AUC:0.641,p=0.001)表明,单核细胞的最佳截断值>0.45 K/uL,其灵敏度为 81.82%,特异性为 58.06%。

结论

外周血单核细胞计数>0.45 k/uL 可作为慢性冠状动脉综合征有症状患者存在显著冠状动脉疾病的预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd04/11544409/25bbd3f2149b/cardj-31-5-722f1.jpg

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