Clinical Research About Status Of Coronary Heart Disease Patients With Abnormal Glucose Metabolism

Objective: To investigate the status of coronary heart disease(CHD) patients with abnormal glucose metabolism(AGM) by retrospective analysis and probe the correlation between AGM and the severity of coronary artery stenosis,it provides a basis for prevention and treatment of CHD patients.Methods: 344 CHD cases were admitted to the 1st affiliated hospital of Shantou University Medical College and underwent coronary angiography from Jan 1st, 2008 to Jun 30th, 2009, and according to the excluding criteria, 201 cases were included in the research. According to the glucose metabolism states, they were divided into control group with normal glucose metabolism (non-AGM-group) and the other group with abnormal glucose metabolism (AGM group), compared with gender, age, the course and grade of hypertension, total cholesterol, triglyceride, low density lipoprotein cholesterol, smoking history, family history of CHD, Gensini score and coronary angiography results. Logestic regression analysis was used to analyze the correlation between each risk factor of CHD and the Gensini score.Results:1. The age ranged from 25 to 87, and the mean age was 62.00±11.46 years.The incidence was significantly increased after 45-year-old. Furthermore, the median of Gensini score in the 45-49 age group was the highest after 45-year-old. There were 62 newly diagnosed cases accompanied with abnormal glucose metabolism, accounting for 30.85% of the total, including 24 patients with type 2 diabetes mellitus and 38 cases with impaired glucose tolerance and impaired fasting plasma glucose, accounting for 11.94% and 18.91% respectively. There were 90 patients with hypertension and coronary heart disease cases, accounting for 44.78%, of which 47 patients received antihypertensive therapy. There were 133 smokers, 123 patients with dyslipidemia, 14 cases with positive family history, accounting for 66.12%, 61.19% and 6.97% respectively. 2. To compare with the gender, age, the course and grade of hypertension, smoking history, family history, total cholesterol, triglyceride and low density lipoprotein cholesterol, there was no significant differences (P>0.05) between two groups, whereas remarkable differences (P<0.01 ) was found in the Gensini score.3. The CHD patients with AGM had an higher incidence of multi-vessel disease, diffuse disease, left main disease and severe stenosis than those with normal glucose metabolism. There was significant differences(P<0.05).4. The result from Logistic regression analysis of Gensini score and the risk factors for CHD suggested that the partial regression coefficient of men,AGM and dyslipidemia had statistically significant (P<0.05), and the most influential was the AGM (P<0.01) ,with a max partial regression coefficient (β=1.531) and Wald values (13.686).Conclusions:1. Younger age of onset of coronary heart disease is closely related with various risk factors, particularly the abnormal glucose metabolism.2. The severity of coronary artery stenosis is positively correlated with AGM.3. Pay attention to the status of glucose metabolism in the diagnosis and treatment of CHD, and run 2-hour postprandial blood glucose test or glucose tolerance test routinely.