Correlation Between Intravascular Ultrasound Atherosclerotic Plaques Morphology And Serous Hypersensitive C-reactive Protein In Patients With Premature Coronary Heart Disease

Backgroud The current study on premature CHD stenosis mainly focus on coronary artery angiography or heart transplantation donor,but few study are conducted in vivo.Objectives:To investigate the relationship between intravascular ultrasound(IVUS) imaging characteristics and plasma hypersensitive C-reaction protein of premature coronary heart disease(CHD) and to assess 12-month clinical follow-up outcomes.Methods From April 2004 to April 2007,620 patients were examined by IVUS,175 patients(118 patients with premature CHD and 57 patients with late CHD) were enrolled according to the plaque characteristics in this study.Comparative study is conducted on 57 patients of premature CHD and 57 patients of late CHD whose data were intact and could be analyzed,and the clinical follow-up is also completed at 12 months after the procedure.Results among the 118 patients of premature CHD,the ratio of lipid core measured by IVUS to plaque of coronary artery was in linear relationship with plasma hypersensitive CRP(R=0.298,R²=0.088,P＜0.001). Comparison between premature CHD patients and late CHD patients,we found that the former has more patients with family history of CHD, smoking,myocardial infarction,hyperlipaemia and unstable angina pectoris(all the P value＜0.05),while the latter has more patients with diabetes.There was no difference between the two groups on the morphology of the lesions by coronary artery angiography.But we could found that lesion extent,cross-sectional areas surrounded by external elastic membrane,eccentricity index(EI),plaque plus medial area(MA), positive remodeling,plaque burden and the ratio of lipid core to plaque by IVUS were usually seen in the group of premature CHD patients(all the P value＜0.05).There was no difference on major adverse cardiac events[MACE,including all-cause death,target-vessel revascularization (TVR),Target lesion revascularization(TLR) and stent thrombosis]rate between the two groups at 12-month clinical follow-up.The MACE rate was 7.89%(9/114).Three and four patients suffered from TVR and TLR and two patients died.There was only 1 patient dead from late stent thrombosis in the two groups(0.87%).Conclusions:compared with late CHD patients,the coronary artery atherosclerotic plaque of premature CHD patients has higher percentage of unstable plaque.The ratio of lipid core to plaque is in positive correlation with plasma hypersensitive CRP in a certain patients.Positive remodeling is a common phenomenon in premature CHD patients. Partâ…¡Intravascular Ultrasound(IVUS) characteristics of Premature Coronary Heart Disease(CHD) Patients With Different Risk FactorsObjectives:To observe lesion characteristics of premature coronary heart disease(CHD) patients with different risk factors by intravascular ultrasound(IVUS).Methods:among 114 premature CHD patients examined by IVUS,quantitative method and qualitative method were adopted to analyze characteristics of coronary artery plaques,and to observe the proportion of different plaques,cross-sectional areas(CSA) surrounded by external elastic membrane,lumen CSA,plaque burden, lumen area stenosis rate and remodeling index of patients with different risk factors.Results:among the CHD patients with traditional risk factors,there is no statistical difference except in lesion extent and minimum lumen diameter among those CHD patients with hypertension. The lesions are serious and higher ratio of lipid core to plaque among those CHD patients with diabetes.More soft plaques and mixed plaques are observed among those CHD patients with hyperlipidemia.Lesion length and the ratio of lipid core to plaque were significant difference between prmature CHD patients with hyperlipidemia and control grous. There is no difference on lesion characteristics detected by IVUS between patients with and without family history of CHD.There are more soft plaques and mixed plaques in the premature CHD patients in cureent smoking group(the P value were＜0.05).The lesions were more serious in current smoking patients than those without smoking patients.There were more ruptured plaques in diabetes group.Positive remodeling is a common phenomenon in diabetes group,while more negative remodeling were observed in other groups.Conclusions:the ratio of lipid core to plaque tends to be higher in group with risk factors than that in group without risk factors.More ruptured plaques were observed among those CHD patients with diabetes.Therefore,these risk factors should be strictly controlled in primary prevention of CHD. Partâ…¢Angiographic Characteristics of Premature Coronary Heart Disease—analyses of single centerBackground There are no large-sample published reports prospectively or consecutively assessing the angiographic characteristics of premature coronary heart disease in China.Objectives The present study was carried out to collect and analyze the clinical and angiographic characteristics in a single center Methods From April 2004 to April 2008,based on the screening condition of male(＜55 years) and female(＜65 years),we selected premature coronary heart disease from a dedicated database of coronary angioplasty registry of the Center for Diagnosis & Treatment of Coronary Artery Disease,Fuwai Hospital.They had been subjected to coronary angiogram due to the angina pectoris or asymptomatic myocardial ischemia in coronary heart disease.Results 4478 consecutive patients (3056 males,1422 females),average age was(49.9±7.0) years,were defined as coronary heart disease according to clinical manifestation and coronary angiogram.Patients with unstable angina pectoris(UAP),stable angina pectoris(SAP) and without angina pectoris were 2400,1534 and 544,respectively.The proportion of coronary heart disease,hypertension, hyperlipidemia,diabetic mellitus(DM),smoking history,prior myocardial infarction(MI),prior percutaneous intervention(PCI), coronary artery bypass graft and history of cerebrovascular diseases were 6.7%,53.0%,35.3%,20.8%,90.3%,43.3%,16.6%,1.5%,1.1%, respectively.The ratio of eccentric lesions,concentric lesions,chronic total occlusion lesions(CTO) and calcified lesions were 93.7%,23%and 42.8%,respectively.Comparison between UAP and SAP,there was more MI,PCI,complex lesions(B₂+C),eccentric lesions and calcium lesions among 3934 patients.There were more MI,PCI,DM,hyperlipidemia, hypertension,cerebrovascular diseases,smoking,eccentric lesions complex lesions,angulated lesions and calcified lesions in male than that in female(all P＜0.05).Conclusions The ratio of sex and clinical findings are different in Chinese Premature coronary heart patients.There were more MI,PCI,complex lesions,eccentric lesions and calcified lesions in UAP group,comparison between sexes,there were higher incidences of hypertension,hyperlipidemia,cerebrovascular disease and smoking history in male.