Bie Bike, Yang Dezhong
Daping Hospital, The Third Military Medical University (Army Medical University), 10th Changjiangzhilu Road, Yuzhong District, Chongqing, 400042, People's Republic of China.
Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), 10th Changjiangzhilu Road, Yuzhong District, Chongqing, 400042, People's Republic of China.
BMC Cardiovasc Disord. 2025 Aug 2;25(1):569. doi: 10.1186/s12872-025-05063-2.
This study aims to evaluate the predictive value of heart rate combined with arteriosclerosis index on the degree of left coronary artery(LCA) lesions in patients with acute coronary syndromes(ACS).
Patients diagnosed with ACS who were discharged from the Department of Cardiovascular Medicine of the Army Characteristic Medical Center from 2019 to 2024 were included, and the relevant clinical data of the selected patients were collected through the electronic medical record database system. According to the results of coronary angiography, they were divided into mild lesion group (All lesions in the left coronary artery (including its branches) with a stenosis degree less than 70%, n = 121) and severe lesion group (any one or more vessels (including their branches) in the left coronary artery with a stenosis degree of 70% or more was the severe lesion group, n = 264).
In ACS patients with concomitant LCA and right coronary artery (RCA) lesions, the results of Spearman correlation analysis indicated that heart rate (r = 0.1948, P = 0.0001) and arteriosclerosis index (r = 0.1636, P = 0.0013) were positively correlated with the Gensini score of the LCA in coronary angiography. The results of multivariate logistic regression analysis suggested that heart rate (HR:1.062, 95%CI:1.040-1.083, P < 0.001), arteriosclerosis index (HR:1333, 95%CI:1.045-1.699, P = 0.021), and age (HR:1.023, 95%CI:1.003-1.042, P = 0.021) were all independent predictors of severe lesions in the LCA. The ROC curve showed that heart rate(AUC = 0.70) and arteriosclerosis index(AUC = 0.59) had certain predictive value for the degree of LCA lesions, and the predictive value of combined assessment was higher (AUC = 0.72). In ACS patients with isolated LCA lesions, both HR (r = 0.0299, P = 0.7424) and AI (r = 0.1930, P = 0.0325) remained positively correlated with the severity of LCA lesions. The results of multivariate logistic regression analysis suggested that heart rate (HR:1.044, 95%CI:1.004-1.085, P = 0.032) and arteriosclerosis index (HR:1.72, 95%CI:1.001-2.955, P = 0.049) were all independent predictors of severe lesions in the LCA. The ROC curve showed that heart rate(AUC = 0.64) and arteriosclerosis index(AUC = 0.64) had certain predictive value for the degree of LCA lesions, and the predictive value of combined assessment was higher (AUC = 0.71).
The combination of HR and AI demonstrates predictive value for LCA lesion severity in ACS patients.
本研究旨在评估心率联合动脉硬化指数对急性冠状动脉综合征（ACS）患者左冠状动脉（LCA）病变程度的预测价值。
纳入2019年至2024年从陆军特色医学中心心血管内科出院的确诊为ACS的患者，并通过电子病历数据库系统收集所选患者的相关临床资料。根据冠状动脉造影结果，将他们分为轻度病变组（左冠状动脉（包括其分支）所有病变狭窄程度小于70%，n = 121）和重度病变组（左冠状动脉中任何一支或多支血管（包括其分支）狭窄程度达到或超过70%为重度病变组，n = 264）。
在合并LCA和右冠状动脉（RCA）病变的ACS患者中，Spearman相关性分析结果表明，心率（r = 0.1948，P = 0.0001）和动脉硬化指数（r = 0.1636，P = 0.0013）与冠状动脉造影中LCA的Gensini评分呈正相关。多因素逻辑回归分析结果提示，心率（HR：1.062，95%CI：1.040 - 1.083，P < 0.001）、动脉硬化指数（HR：1.333，95%CI：1.045 - 1.699，P = 0.021）和年龄（HR：1.023，95%CI：1.003 - 1.042，P = 0.021）均为LCA重度病变的独立预测因素。ROC曲线显示，心率（AUC = 0.70）和动脉硬化指数（AUC = 0.59）对LCA病变程度有一定预测价值，联合评估的预测价值更高（AUC = 0.72）。在孤立LCA病变的ACS患者中，HR（r = 0.0299，P = 0.7424）和AI（r = 0.1930，P = 0.0325）仍与LCA病变严重程度呈正相关。多因素逻辑回归分析结果提示，心率（HR：1.044，95%CI：1.004 - 1.085，P = 0.032）和动脉硬化指数（HR：1.72，95%CI：1.001 - 2.955，P = 0.049）均为LCA重度病变的独立预测因素。ROC曲线显示，心率（AUC = 0.64）和动脉硬化指数（AUC = 0.64）对LCA病变程度有一定预测价值，联合评估的预测价值更高（AUC = 0.71）。
HR和AI联合对ACS患者LCA病变严重程度具有预测价值。
