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According to the results of coronary angiography, they were divided into mild lesion group (All lesions in the left coronary artery (including its branches) with a stenosis degree less than 70%, <jats:italic>n<\/jats:italic>\u2009=\u2009121) and severe lesion group (any one or more vessels (including their branches) in the left coronary artery with a stenosis degree of 70% or more was the severe lesion group, <jats:italic>n<\/jats:italic>\u2009=\u2009264).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In ACS patients with concomitant LCA and right coronary artery (RCA) lesions, the results of Spearman correlation analysis indicated that heart rate (<jats:italic>r<\/jats:italic>\u2009=\u20090.1948, <jats:italic>P<\/jats:italic>\u2009=\u20090.0001) and arteriosclerosis index (<jats:italic>r<\/jats:italic>\u2009=\u20090.1636, <jats:italic>P<\/jats:italic>\u2009=\u20090.0013) were positively correlated with the Gensini score of the LCA in coronary angiography. The results of multivariate logistic regression analysis suggested that heart rate (HR:1.062, 95%CI:1.040\u20131.083, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), arteriosclerosis index (HR:1333, 95%CI:1.045\u20131.699, <jats:italic>P<\/jats:italic>\u2009=\u20090.021), and age (HR:1.023, 95%CI:1.003\u20131.042, <jats:italic>P<\/jats:italic>\u2009=\u20090.021) were all independent predictors of severe lesions in the LCA. The ROC curve showed that heart rate(AUC\u2009=\u20090.70) and arteriosclerosis index(AUC\u2009=\u20090.59) had certain predictive value for the degree of LCA lesions, and the predictive value of combined assessment was higher (AUC\u2009=\u20090.72). In ACS patients with isolated LCA lesions, both HR (<jats:italic>r<\/jats:italic>\u2009=\u20090.0299, <jats:italic>P<\/jats:italic>\u2009=\u20090.7424) and AI (<jats:italic>r<\/jats:italic>\u2009=\u20090.1930, <jats:italic>P<\/jats:italic>\u2009=\u20090.0325) remained positively correlated with the severity of LCA lesions. The results of multivariate logistic regression analysis suggested that heart rate (HR:1.044, 95%CI:1.004\u20131.085, <jats:italic>P<\/jats:italic>\u2009=\u20090.032) and arteriosclerosis index (HR:1.72, 95%CI:1.001\u20132.955, <jats:italic>P<\/jats:italic>\u2009=\u20090.049) were all independent predictors of severe lesions in the LCA. The ROC curve showed that heart rate(AUC\u2009=\u20090.64) and arteriosclerosis index(AUC\u2009=\u20090.64) had certain predictive value for the degree of LCA lesions, and the predictive value of combined assessment was higher (AUC\u2009=\u20090.71).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The combination of HR and AI demonstrates predictive value for LCA lesion severity in ACS patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12872-025-05063-2","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T05:28:12Z","timestamp":1754112492000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prediction value of heart rate combined with arteriosclerosis index for left coronary artery lesion in patients with ACS"],"prefix":"10.1186","volume":"25","author":[{"given":"Bike","family":"Bie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dezhong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,2]]},"reference":[{"issue":"7","key":"5063_CR1","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1001\/jama.2022.0358","volume":"327","author":"DL Bhatt","year":"2022","unstructured":"Bhatt DL, Lopes RD, Harrington RA. 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Informed consent was exempted by the Institutional Review Board of Army Medical Center(refer to the supplementary materials).This study was granted a waiver of informed consent for the following reasons: The medical records and biospecimens utilized were obtained during routine clinical care prior to this retrospective study; The retrospective design made it impracticable to obtain individual consent; The research posed no greater than minimal risk to participants; Waiver of consent would not adversely affect subjects\u2019 rights or welfare; All protected health information was de-identified to ensure confidentiality.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"569"}}