The Correlation To Coronary Heart Disease And To The Severity Of Coronary Artery Lesions Of Nonhdl-C Concentration

Background and ObjectAs a great deal of studies have shown nonHDL-C a stronger predictor of CHD than LDL-C in the patients with elevated TGs(≥200mg/dl), NCEP ATP Ⅲ identified nonHDL-C the secondary therapeutic target for such people. In Japan, the populations are less obese and have lower concentrations of TC and higher concentration of HDL-C than those in western countries, and it show that higher concentration of nonHDL-C were associated with an increased risk of mortality from CHD for men. And then, in China, likely in Japan, the populations are less hyperlipidemia or obese than the west, our study aim to discuss whether the nonHDL-C concentration could be a better measure item for CHD than LDL-C, and to analyze the relationship between its concentration and the severity of coronary lesions.Materials and methodCompleted data includes the patients admitted to the department of cardiology of Huadong Hospital those who came to our clinic service because of chest pain from January1st to December31st in2009, excluding those who were taking drugs reducing blood cholesterol and those who had taken CABG or stents inputted.After they admitted in, patients are divided into two groups according to the result of coronary arteriography:non-CHD and CHD, we compare the nonHDL-C concentration between two groups using t test and logistic regression analysis, partial correlation analysis.We use ROC curves to get the cut point of nonHDL-C concentration and other items diagnosing CHD, and then compare them to decide which is better.The patients are divided into three groups according to the result of coronary arteriography:normal, coronary atherosclerosis and CHD, and then those who are in CHD group are divided into three groups again:single branch artery lesion, two branches artery lesion, three branches or left main artery lesion. Comparing the nonHDL-C concentration and other items among the groups, we discuss the relationship between nonHDL-C and the extent of coronary artery lesions.At last, we analyze the relationship between the nonHDL-C concentration and Gensini’s score to explore its correlation to the severity of coronary artery lesions.We use a software of SPSS16.0for statistics analysis, it is considered to be statistic meaningful while P<0.05. Measurement data is described by mean±standard deviation(x±s), categorical data is described by percentage(%). We use t test to analyze the difference between two groups. We use logistic regression analysis to analyze multiple factors, and calculate odd ratio and95%confidence interval. We use ROC of nonHDL-C and LDL-C concentration to compare their different in judging CHD.ResultsData includes236patients (male138, female98, mean age66.2±9.6) admitted to this study.Between CHD group and non-CHD group, objects show statistic meaningless on age, sex, DM, HBP, Hyperlipidemia(HLP), smoke and BMI, but show statistic meaningful on TC, HDL-C, LDL-C, nonHDL-C. Only nonHDL-C and TC show statistic meaningful when using logistic regression analysis, and the OR of the former is7.658(95%CI2.677-22.058, P=0.000), which also show statistic meaningful when using partial correlation analysis, this means that the difference of nonHDL-C between two groups is meaningful and independent.The cut point of nonHDL-C concentration is3.68mmol/L (141mg/dl), the area under the ROC curve was0.607±0.037(P=0.004). When compared with LDL-C, nonHDL-C shows similar sensitivity, specificity, positive predictive value, positive predictive value and accuracy.NonHDL-C concentration and LDL-C concentration both show statistic meaningful among normal group, coronary atherosclerosis group and CHD group (P=0.002, P=0.011). But only nonHDL-C concentration show statistic meaningful among single branch artery lesion group, two branches artery lesion group and three branches or left main artery lesion group (P=0.018).When we analyze the relationship between nonHDL-C concentration and Gensini’s score, we get the meaningful result (correlation coefficient is0.293, P=0.000), which suggest the positive linear correlation between the two. In those who are not younger than75, we can also find statistic meaningful between the two (correlation coefficient is0.473, P=0.000), but not between LDL-C concentration and Gensini’s score (P=0.097).ConclusionThe concentration of nonHDL-C between CHD and non-CHD person is different and this difference is statistic meaningful and independent, its ROC curve result is similar to LDL-C, so we consider its relationship to CHD is not bad than LDL. Secondary, nonHDL-C concentration rise with the development of coronary artery lesion, and it shows statistic meaningful with Gensini’s score, so we consider it partly reflect the severity of coronary artery lesion. In those who are not younger than75, we can find statistic meaningful between nonHDL-C concentration and Gensini’s score but not between LDL-C concentration and Gensini’s score, so we consider that nonHDL-C maybe better than LDL-C under such specific conditions. Overall, nonHDL-C may become a good item to measure and to estimate the severity of coronary artery lesion, as which is simply calculated without the effects of diet or TG concentration.