Predictor analysis of abnormal coronary flow reserve in women with non-obstructive coronary artery disease

doi:10.3969/j.issn.1004-583X.2022.09.004

Abstract

Abstract:

Objective To explore the predictors and clinical features of abnormal coronary flow reserve (CFR) in women with non-obstructive coronary artery disease (NOCAD). Methods We performed a retrospective analysis of 223 NOCAD female patients from the aspects of general clinical features, vital signs, left-ventricular ejection fraction (LVEF) on the echocardiography during hospitalization, nuclear myocardial perfusion imaging parameters and laboratory blood tests indexes for further statistical analysis. The patients were divided into two groups: normal CFR group (CFR≥2.5) and abnormal CFR group (CFR<2.5). Results The levels of total cholesterol and low density lipoprotein cholesterol (LDL-C) were significantly higher in abnormal CFR group than those in normal CFR group (P=0.011, P=0.002). Multiple logistic regression analysis revealed that LDL-C level was only found to be independently associated with abnormal CFR (OR=3.346; 95%CI=1.254-8.930; P=0.016). The receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off value of LDL-C level for predicting abnormal CFR was 3.36 mmol/L with a sensitivity of 40% and specificity of 77% (AUC=0.609; 95%CI=0.535-0.683).Conclusion The LDL-C level is found to be independently associated with abnormal CFR in NOCAD female patients, and coronary microvascular dysfunction is more likely to occur in women with abnormal LDL-C level.

Key words: coronary artery disease, microvascular dysfunction, radionuclide imaging, myocardial perfusion imaging, fractional flow reserve, myocardial

CLC Number:

R541.4

Wang Yajie, Li Jianming, Liu Jingjing, Lu Yujie, Lin Wenhua. Predictor analysis of abnormal coronary flow reserve in women with non-obstructive coronary artery disease[J]. Clinical Focus, 2022, 37(9): 791-795.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.09.004

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I9/791

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References 19

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项目	CFR正常组(n=114)	CFR异常组(n=109)	统计值	P值
年龄(岁)	60.31±8.66	62.49±8.15	-1.934	0.054
BMI(kg/m²)	25.08(4.97)	25(4.44)	-0.105	0.916
高血压[例(%)]	62(54.4)	58(53.2)	0.031	0.860
糖尿病[例(%)]	29(25.4)	29(26.6)	0.039	0.843
目前仍吸烟[例(%)]	11(9.6)	12(11.0)	0.111	0.739
收缩压(mmHg)	130.50(20.25)	133(19)	-0.925	0.355
舒张压(mmHg)	79(15.5)	78(14.5)	-0.316	0.752
心率(次/min)	70(16)	72(13)	-0.564	0.573
白细胞总数(10⁹/L)	5.5(1.85)	5.3(1.7)	-0.364	0.716
血红蛋白(g/L)	131.09±10.40	132.80±9.55	-1.277	0.203
血小板计数(10⁹/L)	243.90±65.46	249.28±55.22	-0.662	0.509
空腹血糖(mmol/L)	5.3(1.43)	5.4(1.75)	-0.642	0.521
肌酐(μmol/L)	50(10.5)	53(12)	-1.193	0.233
MDRD-eGFR[ml/(min·1.73 m²)]	116.87±22.01	112.52±24.52	1.394	0.165
尿酸(μmol/L)	288.09±70.32	300.60±74.25	-1.292	0.198
总胆固醇(mmol/L)	4.6(1.1)	4.8(1.55)	-2.538	0.011
甘油三酯(mmol/L)	1.39(1.02)	1.32(0.92)	-1.136	0.256
HDL-C(mmol/L)	1.29(0.45)	1.26(0.32)	-0.383	0.702
LDL-C(mmol/L)	2.78±0.87	3.17±0.97	-3.182	0.002
LVEF(%)	66(6)	66(6)	-0.226	0.821
左心室整体CFR值	3.20(0.84)	1.85(0.70)	-12.901	<0.01
左心室静息心肌血流量[ml/(min·g)]	0.9(0.13)	0.89(0.12)	-0.262	0.793
左心室负荷心肌血流量[ml/(min·g)]	2.81±0.67	1.60±0.42	16.319	<0.01

项目	CFR正常组(n=114)	CFR异常组(n=109)	统计值	P值
年龄(岁)	60.31±8.66	62.49±8.15	-1.934	0.054
BMI(kg/m²)	25.08(4.97)	25(4.44)	-0.105	0.916
高血压[例(%)]	62(54.4)	58(53.2)	0.031	0.860
糖尿病[例(%)]	29(25.4)	29(26.6)	0.039	0.843
目前仍吸烟[例(%)]	11(9.6)	12(11.0)	0.111	0.739
收缩压(mmHg)	130.50(20.25)	133(19)	-0.925	0.355
舒张压(mmHg)	79(15.5)	78(14.5)	-0.316	0.752
心率(次/min)	70(16)	72(13)	-0.564	0.573
白细胞总数(10⁹/L)	5.5(1.85)	5.3(1.7)	-0.364	0.716
血红蛋白(g/L)	131.09±10.40	132.80±9.55	-1.277	0.203
血小板计数(10⁹/L)	243.90±65.46	249.28±55.22	-0.662	0.509
空腹血糖(mmol/L)	5.3(1.43)	5.4(1.75)	-0.642	0.521
肌酐(μmol/L)	50(10.5)	53(12)	-1.193	0.233
MDRD-eGFR[ml/(min·1.73 m²)]	116.87±22.01	112.52±24.52	1.394	0.165
尿酸(μmol/L)	288.09±70.32	300.60±74.25	-1.292	0.198
总胆固醇(mmol/L)	4.6(1.1)	4.8(1.55)	-2.538	0.011
甘油三酯(mmol/L)	1.39(1.02)	1.32(0.92)	-1.136	0.256
HDL-C(mmol/L)	1.29(0.45)	1.26(0.32)	-0.383	0.702
LDL-C(mmol/L)	2.78±0.87	3.17±0.97	-3.182	0.002
LVEF(%)	66(6)	66(6)	-0.226	0.821
左心室整体CFR值	3.20(0.84)	1.85(0.70)	-12.901	<0.01
左心室静息心肌血流量[ml/(min·g)]	0.9(0.13)	0.89(0.12)	-0.262	0.793
左心室负荷心肌血流量[ml/(min·g)]	2.81±0.67	1.60±0.42	16.319	<0.01

预测变量	单因素分析							多因素分析
	回归系数	标准误	Wald χ²值	P值	OR值	95%CI		回归系数	标准误	Wald χ²值	P值	OR值	95%CI
	回归系数	标准误	Wald χ²值	P值	OR值			回归系数	标准误	Wald χ²值	P值	OR值			下限	上限	下限	上限
年龄	0.031	0.016	3.649	0.056	1.032	0.999	1.065	0.031	0.017	3.296	0.069	1.031	0.998	1.065
总胆固醇	0.330	0.134	6.028	0.014	1.390	1.069	1.809	-0.702	0.442	2.526	0.112	0.496	0.209	1.178
LDL-C	0.469	0.154	9.327	0.002	1.598	1.183	2.160	1.208	0.501	5.816	0.016	3.346	1.254	8.930

预测变量	单因素分析							多因素分析
	回归系数	标准误	Wald χ²值	P值	OR值	95%CI		回归系数	标准误	Wald χ²值	P值	OR值	95%CI
	回归系数	标准误	Wald χ²值	P值	OR值			回归系数	标准误	Wald χ²值	P值	OR值			下限	上限	下限	上限
年龄	0.031	0.016	3.649	0.056	1.032	0.999	1.065	0.031	0.017	3.296	0.069	1.031	0.998	1.065
总胆固醇	0.330	0.134	6.028	0.014	1.390	1.069	1.809	-0.702	0.442	2.526	0.112	0.496	0.209	1.178
LDL-C	0.469	0.154	9.327	0.002	1.598	1.183	2.160	1.208	0.501	5.816	0.016	3.346	1.254	8.930