Analysis of TyG Index,Culprit Vessel and Ventricular Remodeling in Patients with Acute Myocardial Infarction of Different Traditional Chinese Medicine Syndrome Types
Objective:To observe the clinical differences in TyG index,types of lesion vessels,and ventricular remodeling in patients with acute myocardial infarction(AMI)of different TCM syndrome types.Methods:A total of 115 patients were selected.According to the"Clinical Guidelines for the TCM Diagnosis and Treatment of Acute Myocardial Infarction",they were classified into six TCM syndromes:phlegm-stasis intermingled syndrome,qi deficiency and blood stasis syndrome,qi stagnation and blood stasis syndrome,cold coagulation in the heart me-ridian syndrome,qi and yin deficiency syndrome,and qi deficiency and yang collapse syndrome.The differences in the number of coronary artery lesions,types of lesion vessels,TyG index,and ventricular remodeling among pa-tients with different TCM syndromes were analyzed.Results:Among the 115 patients with AMI,there were 41 cas-es of phlegm-stasis intermingled syndrome,28 cases of qi deficiency and blood stasis syndrome,29 cases of qi stagnation and blood stasis syndrome,15 cases of qi and yin deficiency syndrome,2 cases of qi deficiency and yang collapse syndrome,and 0 cases of cold coagulation in the heart meridian syndrome.For lesions in the anteri-or descending branch,the distribution of TCM syndromes was in order of qi stagnation and blood stasis＞qi and yin deficiency＞phlegm-stasis intermingled＞qi deficiency and blood stasis.For lesions in the right coronary ar-tery,the distribution was phlegm-stasis intermingled＞qi and yin deficiency＞qi deficiency and blood stasis＞qi stagnation and blood stasis.For lesions in the circumflex artery,the predominant TCM syndromes were qi deficien-cy and blood stasis and phlegm-stasis intermingled.Single vessel lesions were predominantly qi stagnation and blood stasis,followed by phlegm-stasis intermingled.Two-vessel lesions were predominantly qi deficiency and blood stasis,followed by qi stagnation and blood stasis.Three-vessel lesions were predominantly qi and yin defi-ciency,followed by phlegm-stasis intermingled.The TyG index in patients with phlegm-stasis intermingled syn-drome was significantly higher than in patients with qi deficiency and blood stasis syndrome and qi stagnation and blood stasis syndrome(P＜0.05),but not significantly different from patients with qi and yin deficiency syndrome(P＞0.05).The triglyceride levels in patients with phlegm-stasis intermingled syndrome were significantly higher than in patients with qi deficiency and blood stasis syndrome,qi and yin deficiency syndrome,and qi stagnation and blood stasis syndrome(P＜0.05).There was no significant difference in total cholesterol,high-density lipopro-tein,and low-density lipoprotein levels among the four groups(P＞0.05).There was no significant difference in ejection fraction(EF),left ventricular end-diastolic diameter(LVEDD),and left ventricular end-systolic diameter(LVESD)values among the four groups(P＞0.05).Spearman correlation analysis showed a positive correlation be-tween the phlegm-stasis intermingled syndrome in LVEDD(r=0.204,P＜0.05).Conclusion:The number of coro-nary artery lesions,TyG index,triglycerides,and types of lesion vessels are associated with TCM syndromes in pa-tients with AMI.Patients with phlegm-stasis intermingled syndrome have the highest TyG index.Patients with multi-vessel lesions in AMI all have qi deficiency syndrome.The phlegm-stasis intermingled syndrome in AMI is positively correlated with LVEDD.The TyG index and LVEDD have reference significance for the differentiation of the phlegm-stasis intermingled syndrome in AMI.
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