Abstract:

Objective To explore the predictive value of parathyroid hormone (PTH) and carotid intima-media thickness (IMT) on the degree of coronary artery calcification (CAC). Methods The clinical data of 164 patients with suspected coronary heart disease hospitalized in the First Affiliated Hospital of Dali University from December 2018 to March 2020 were retrospectively analyzed. According to the coronary artery calcification score (CACS), the patients were allocated to non-calcification group (CACS=0, n=63) and the calcification group (CACS>0, n=101). CAC-associated factors were identified. Clinical data between different groups were compared, including PTH and IMT. Independent risk or protective factors for CAC were identified by univariable logistic regression analysis. The predictive efficacy of PTH, IMT and their combination on CAC was analyzed by plotting the receiver operating characteristic (ROC) curves. The cut-off value was determined based on the Youden index, and the corresponding specificity and sensitivity were calculated. The area under the curve (AUC) was calculated to assess the diagnostic potential.Results There were significant differences in age, blood glucose, PTH and IMT between the groups (P<0.05). Compared with the non-calcification group, the levels of the above indicators in the calcification group were significantly higher(P<0.05). The PTH level in the severe calcification group was significantly higher than that in the moderate, mild and lesscalcification groups, and the PTH level in the moderate calcification group was significantly higher than that in the mild and lesscalcification groups (P<0.01). There was no significant difference in IMT among groups (P>0.05).The ROC curves were plotted with PTH and IMT as test variables and CAC as state variable. The combination detection of PTH and IMT presented the best diagnostic potential in CAC, followed by the single detection of PTH, and IMT. When PTH was greater than 77 pg/ml, the possibility of CAC was greater. When IMT was greater than 0.98 mm, the possibility of CAC was also greater. After calculating AUC, PTH, IMT and their combination were all able to predict CAC. The pairwise comparison showed that the diagnostic potential of the combination detection of PTH and IMT was superior to their single detection. ROC curves of PTH, IMT and their combination were drawn. AUC>0.7 suggested a certain predictive effect, and AUC>0.9 suggested an acceptable predictive value. Conclusion The predictive effect of PTH on CAC is significantly higher than that of IMT.The predictive effect of PTH combined with IMT is higher than that of PTH or IMT alone. It can be used for clinical reference.

Key words: coronary artery calcification, parathyroid hormone, carotid artery intima-media thickness, predictive function