The Journal of Practical Medicine >
Analysis of skin cholesterol determination combined with ECG treadmill exercise in diagnosis of coronary heart disease in patients with atypical chest pain
Received date: 2023-05-04
Online published: 2023-11-15
Objective To explore the clinical predictive value of skin cholesterol and electrocardiogram treadmill exercise (EET) for coronary heart disease (CHD) in patients with atypical chest pain. Methods One hundred and twenty-eight patients with atypical chest pain admitted from April 2020 to April 2021 were enrolled. All patients did not take any lipid-lowering drugs or anti-myocardial ischemia drugs within 1 month before admission. Skin cholesterol content test, EET test, coronary angiography, Gensini score and number of diseased vessels were completed during hospitalization. According to the results of coronary angiography, the patients were divided into CHD group and non-CHD group. General clinical data, skin cholesterol content and EET results of the two groups were analyzed. Correlation analysis was performed between skin cholesterol content and Gensini score. Multivariate logistic regression was used to screen factors with predictive value for the diagnosis of CHD in patients with atypical chest pain. Results The content of cholesterol in skin increased significantly in patients with CHD. With the increase of the number of coronary artery lesions, the content of cholesterol in skin also increased significantly. Skin cholesterol content was positively correlated with Gensini score. Logistic regression analysis showed that skin cholesterol content and EET positive were predictors of CHD. The area under ROC curve of skin cholesterol content and EET in predicting the diagnosis of CHD in patients with atypical chest pain was 0.879 and 0.617, the corresponding sensitivity 86.2% and 67.3%, and the specificity 74.3% and 49.3%, respectively. The area under ROC curve of the combination of the two in predicting the diagnosis of CHD in patients with atypical chest pain was 0.917, and the sensitivity and specificity were 91.5% and 82.3%, respectively. Conclusion Skin cholesterol content is of good value in the diagnosis of CHD in patients with atypical chest pain, and EET can further improve the sensitivity and specificity of diagnosis.
Key words: skin cholesterol; coronary heart disease; area under curve
Kun DU , Wentao CHEN , Xiaoling JU , Jie. WANG . Analysis of skin cholesterol determination combined with ECG treadmill exercise in diagnosis of coronary heart disease in patients with atypical chest pain[J]. The Journal of Practical Medicine, 2023 , 39(20) : 2671 -2675 . DOI: 10.3969/j.issn.1006-5725.2023.20.020
| 1 | MICHAEL T H, ANNE M O F, SHEENA M M, et al. Appropriate use of elective coronary angiography in patients with suspected stable coronary artery disease[J]. Ir J Med Sci, 2019,188(3):807-813. |
| 2 | KHALED M A, MARCUS Y C, AMIT K D, et al. Coronary computed tomography angiography from clinical uses to emergine technologies:JACC State-of-the-art review[J]. J Am Coll Cardiol,2020,76(10):1226-1243. |
| 3 | HALEH A, LEILA G, MASOUD S. Predicting coronary artery disease:a comparison between two data minig algorithms[J]. BMC Public Health,2019,19(1):448. |
| 4 | SIFAN Q, SHOUJIANG Y, YAMINY S, et al. Remnant Cholesterol and common carotid artery intima-media thickness in patients wtih ischemic stroke[J]. Circ Cardiovasc Imaging, 2021,14(4):325-335. |
| 5 | SPRECHER D L, PEARCE G L. Skin cholesterol adds to Framingham risk assessment[J]. Am Heart J,2006,152:694-696. |
| 6 | GEORGIOS P R, GEORGIOS B, DOMINIK C B, et al. A guide for Gensini Score calculation[J]. Atherosclerosis,2019,287:181-183. |
| 7 | 杜冬杰,陈健,王诗悦,等. 血残粒胆固醇水平与冠心病和心肌梗死风险的两样本孟德尔随机化研究[J]. 中国动脉硬化杂志,2023,31(6):510-517. |
| 8 | 来佳成,韩永生,汪庆童,等. 冠心病患者皮肤胆固醇和血清胆固醇的相关性研究[J]. 临床心血管病杂志,2021,37(10):905-909. |
| 9 | SOCHOROVA M, AUDRLICKA P, CERVENA M, et al. Permeability and microstructure of cholesterol-depleted skin lipid membrane and human stratum corneum[J]. J Colloid Interface Sci, 2019,535:227-238. |
| 10 | BISSON B C, CEPHISE V F L, GREGOIRE C A, et al. Skin autofluorescence predicts major adverse cardiovascular events in patients with type 1 diabetes:a 7-year follow-up study[J]. Cardiovasc Diabetol,2018,17(1):82-89. |
| 11 | NI J S, HONG H, ZHANG Y, et al. Development of a non-invasive method for skin cholesterol detection:pre-clinical assessment in atherosclerosis screening[J]. Biomed Eng Online,2021,20(1):52-68. |
| 12 | BHATTTACHARYA N, SATO W J, KELLY A, et al. Epidermal lipids:key mediators of atopic dermatitis pathogenesis[J]. Trends Mol Med,2019,25(6):551-562. |
| 13 | LAI J, HAN Y, HUANG C, et al. Non-invasive skin cholesterol testing:a protential proxy for LDL-C and apoB serum measurements[J]. Lipids Health Dis,2021,20(1):137-146. |
| 14 | TASHAKKOR A Y, MANCINI G B. The relationship between skin cholesterol testing and parameters of cardiovascular risk:a systematic reviem[J]. Can J Cardiol,2013,29(11):1477-1487. |
| 15 | SUN J L, HAN R, GUO J H, et al. The diagnostic value of treadmill exercise test parameters for coronary artery disease[J]. Cell Biochem Biophys,2013,65(1):69-76. |
| 16 | 赵辰佳,杨婧怡,朱桂秋,等. 心电图平板运动实验诊断冠心病假阴性的影响因素分析[J]. 影像研究与医学应用,2021,5(18):223-224. |
/
| 〈 |
|
〉 |