Analysis of the Relationship between the Characteristics of Atherosclerotic Plaque and Serum Hcy and Prognosis in Patients with Coronary Heart Disease Based on Vascular Ultrasound
Objective To explore the relationship between the characteristics of atherosclerotic plaque and serum homocysteine(Hcy)and prognosis in patients with coronary heart disease(CHD)based on vascular ultrasound.Methods 247 patients with coronary heart disease admitted to our hospital from January 2019 to January 2023 were selected and divided into stable plaque group(n=138)and unstable plaque group(n=109)based on the nature of the plaque.Compare the parameters of vascular ultrasound and serum Hcy levels between two groups,and analyze the relationship between serum Hcy and vascular ultrasound parameters using Spearman correlation analysis.Follow up for 1 year,divided into the occurrence group(n=39)and the non occurrence group(n=208)based on the occurrence of cardiovascular events.Logistic regression model was used to analyze the risk factors for cardiovascular adverse events in patients with coronary heart disease.Results The Hcy level in the unstable plaque group was higher than that in the stable plaque group,with a statistically significant difference(P＜0.05).The cross-sectional area(EEM CSA),plaque load(PB),and plaque area(PA)values of the unstable plaque group were higher than those of the stable plaque group,while the minimum lumen cross-sectional area(MLA CSA)value was lower than that of the stable plaque group(P＜0.05).There was a negative correlation between serum Hcy and MLA CSA(r=-0.730,P＜0.05),and a positive correlation with EEM CSA,PB,and PA(r=0.629,0.796,0.601,P＜0.05).Diabetes,smoking history,family history of coronary heart disease,proportion of multiple diseased vessels,serum Hcy level,EEM CSA,PB,PA of patients in the occurrence group were higher than those in the non occurrence group,while MLA CSA was lower than those in the non occurrence group(P＜0.05).The results of multivariate logistic regression analysis showed that low MLA CSA and high EEM CSA,PB,and serum Hcy levels were risk factors for cardiovascular adverse events(P＜0.05).Conclusion Atherosclerotic plaque instability in patients with coronary heart disease is closely related to various parameters of vascular ultrasound and serum Hcy.Both vascular ultrasound and serum Hcy can assess plaque instability,which plays an important role in the clinical treatment and prognosis of coronary heart disease.
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