ABSTRACT
Objective:To evaluate the diagnostic value of Essen stroke risk score(ESRS) combined with neutrophil lymphocyte ratio(NLR) in coronary heart disease(CHD).Methods:From July 1, 2015 to June 30, 2019, patients who were hospitalized in the Second Affiliated Hospital of Anhui Medical University for suspected CHD and underwent coronary angiography were selected as the study objects.According to the results of coronary angiography, these patients were divided into CHD group (stenosis rate ≥ 50%) and control group(stenosis rate<50%). The clinical, laboratory and angiographic data of the two groups were collected, including NLR, ESRS and coronary narrow degree integral(Gensini integral method). Logistic regression model and receiver operator characteristic(ROC) were used to evaluate the diagnostic value of ESRS combined with NLR in CHD.Results:During the study period, 325 patients were enrolled, including 219 CHD patients and 106 controls.The age, hypertension, diabetes mellitus, peripheral artery disease, ESRS, NLR and fasting blood glucose levels in the CHD group were significantly higher than those in the control group(all P<0.05). Spearman correlation analysis showed that ESRS( r=0.515, P<0.001) and NLR( r=0.250, P<0.001) were positively correlated with coronary Gensini score.Two logistic regression models were established, where model 1 was logit(P1)=-2.072+ 0.566×ESRS+ 0.299×NLR+ 0.173×fasting blood glucose(the diagnostic accuracy rate was 71.7%) and model 2 was logit(P2)=-1.169+ 0.594×ESRS+ 0.302×NLR(the diagnostic accuracy rate was 70.8%). There was no significant difference in the diagnostic accuracy between the two models( P=0.499). Finally, logistic regression model 2 was selected as the joint diagnostic model.The area under curve of ESRS, NLR and logistic regression model 2 was 0.713, 0.634 and 0.736, respectively, and the difference was statistically significant(all P<0.05). The diagnostic threshold of ESRS was 2, and the diagnostic threshold of NLR was 2.74.The 95% CI of the joint diagnostic model 2 was (0.684, 0.783), which showed a sensitivity of 60.27% and a specificity of 78.30%.This model was superior to the diagnostic efficacy of ESRS( P=0.047) and NLR( P<0.001). Conclusion:The joint diagnostic model of ESRS combined with NLR is superior to the single index in the diagnosis of CHD, which may thus be used to predict the occurrence of CHD.
ABSTRACT
Objective:To investigate the correlation between serum 25-hydroxyvitamin D [25(OH)D], Essen Stroke Risk Scale (ESRS) and the incidence of coronary atherosclerotic heart disease.Methods:From July 2016 to January 2019, 186 patients who underwent coronary angiography (CAG) in the Department of Geriatric Cardiology at the Second Affiliated Hospital of Anhui Medical University were included.Among them, 117 patients were diagnosed with coronary heart disease, 69 cases without coronary heart disease.The serum 25(OH)D values and ESRS scores of the two groups were collected to analyze the relationship between 25(OH)D, and ESRS scores, coronary heart disease.At the same time, multivariate logistic regression was used to analyze the correlation between serum 25(OH)D and ESRS scores.Results:The serum level of 25(OH)D in the coronary heart disease group was (38.19±16.35)nmol/L, which in the non-coronary heart disease group was (45.37±19.01)nmol/L, the difference was statistically significant difference ( t=2.722, P<0.05). The ESRS scores in the coronary heart disease group was (2.32±1.38)points, which of the non-coronary heart disease group was (1.42±1.32)points, the difference was statistically significant ( t=-4.394, P<0.05). Multivariate logistic regression analysis showed that 25(OH)D was independently associated with coronary heart disease ( OR=0.944, 95% CI: 0.902-0.989, P=0.015), ESRS score was independently associated with coronary heart disease ( OR=1.716, 95% CI: 1.314-2.240, P<0.001). Conclusion:25(OH)D is a protective factor for coronary heart disease, ESRS score is an independent risk factor for coronary heart disease.
ABSTRACT
Atrial fibrillation is one of the important risk factors for ischemic stroke, which can lead to the cardioembolic stroke. On the contrary, ischemic stroke can also result in atrial fibrillation, namely, atrial fibrillation detected after stroke (AFDAS). Studies have shown that the pathophysiological mechanism and prognosis of AFDAS may be different from those of atrial fibrillation known before stroke. The monitoring of AFDAS and its effect on prognosis has become a hot research topic. This article reviews the definition, pathophysiological mechanism, monitoring methods and prognosis of AFDAS.