MHR与高血压合并冠心病患者发生多支血管病变的相关性OACSTPCD

Objective To investigate the relationship between MHR and the occurrence of multivessel dis-ease in patients with hypertension combined with coronary artery disease.Methods A total of 481 inpatients diagnosed with hypertension combined with coronary artery disease in Wuhan Third Hospital from January 2022 to February 2023 were retrospectively enrolled.According to the results of coronary angiography results,patients were divided into the multivessel disease group(226 cases)and the non-multivessel disease group(255 cases);according to MHR value,patients were divided into 160 cases in low MHR group(MHR<0.24),160 cases in middle MHR group(0.24≤MHR<0.37)and 161 cases in high MHR group(MHR≥0.37).Pearson correlation was used to analyze the correlation between MHR and Gensini score;univariate and multi-variate Logistic regression were used to analyze the risk factors for the development of multivessel disease in patients with hypertension combined with coronary artery disease;and the value of MHR in predicting mul-tivessel disease was assessed by plotting the receiver operating characteristic(ROC)curve.Results There were significant differences in gender,body mass index(BMI),heart rate,proportion of patients with smoking history,proportion of patients with drinking history,proportion of patients with diabetes mellitus,as well as white blood cell count(WBC),absolute neutrophil count(NEU),absolute lymphocyte count(LYM),platelet count(PLT),fasting blood glucose(FBG),total cholesterol(TC)and measurement of triglyceride(TG)lev-els and Gensini score among the low MHR group,middle MHR group and high MHR group(P<0.05).Com-parison of gender,BMI,heart rate,proportion of patients with smoking history,proportion of patients with drinking history,proportion of patients with diabetes mellitus,as well as WBC,NEU,FBG,TC,TG levels and MHR scores between the multivessel disease group and non-multivessel disease group showed statistically sig-nificant differences(P<0.05).Multivariate Logistic regression analysis results showed that history of diabe-tes mellitus(OR=2.261,95%CI:1.415-3.612),history of smoking(OR=1.833,95%CI:1.101-3.053),NEU>3.94(OR=1.287,95%CI:1.114-1.487),male(OR=1.566,95%CI:1.024-2.396)and MHR>0.33(OR=2.484,95%CI:1.859～3.320)were independent risk factors for the occurrence of multivessel dis-ease.The results of Pearson's correlation analysis showed a positive correlation between the MHR and the Gensini score(r=0.54,P<0.001).The results of ROC curve analysis showed that the area under the ROC curve for the assessment of multivessel disease in hypertensive patients with coronary artery disease was 0.757(95%CI:0.713-0.800,p<0.001),with an optimal cut-off value of 0.33,a sensitivity of 64.2%and a specificity of 78.8%.Conclusion Elevated MHR is an independent risk factor for the development of mul-tivessel disease in patients with hypertension combined with coronary artery disease,and the MHR can better predict the number of coronary artery vessels in patients with hypertension combined with coronary artery dis-ease.