Abstract:

Objective To explore the application value of detecting serum osmotic pressure （SOSM） in combination with serum N-terminal pro-brain natriuretic peptide （NT-proBNP） and homocysteine （Hcy） in patients with coronary heart disease and hypertension who suffer from acute heart failure. Methods A retrospective study was carried out on 130 patients with coronary heart disease and hypertension who visited the Second People's Hospital of Hefei from January 2023 to December 2024. Based on clinical diagnosis， they were divided into an acute heart failure （AHF） group consisting of 58 cases and a non-acute heart failure group with 72 cases. A control group of 64 patients with simple hypertension was selected during the same period. Serum NT-proBNP， Hcy， and LDL-C were measured in the three groups of patients. SOSM was calculated using serum sodium （Na）， potassium （K）， glucose （GLU）， and urea （UREA） levels， and then a comparison was made to determine whether there were statistical differences in SOSM， NT-proBNP， LDL-C， and Hcy among the three groups. A binary logistic regression analysis was performed on the 130 observation subjects with coronary heart disease complicated by hypertension， and a good diagnostic indicator for acute heart failure in patients with coronary heart disease complicated by hypertension was obtained. The application value of Receiver Operating Characteristic （ROC） curve analysis of various indicator levels in acute heart failure in patients with coronary heart disease and hypertension was also explored. Results The differences in SOSM， Hcy， NT-proBNP， and LDL-C levels among the three groups were statistically significant （P < 0.05）. The levels of NT-proBNP， SOSM， and Hcy in the AHF group were higher than those in the non-AHF group and the control group （P < 0.05）. The ROC curves of the AHF group and the non-AHF group showed that the area under the ROC curve of the combined detection was 0.927， which was higher than that of each individual indicator. The sensitivity increased， and the specificity was high. Conclusion The combined detection of serum NT-proBNP， SOSM， and Hcy plays a crucial role in the early diagnosis and assessment of acute heart failure in patients with coronary heart disease and hypertension.

Key words: coronary atherosclerotic heart disease, heart failure, serum osmotic pressure, N-terminal pro-brain natriuretic peptide, homocysteine