Analysis Of The Risk Factors In Young Men With Coronary Heart Disease

Background Coronary heart disease (CHD) is a common diseases which does great harm to people’s health. Recent clinical studies found that the age of the patients with CHD tends to be young.The incidence of CHD in young men was obviously higher than that in young women. The mean onset age of CHD in males were 10 to 15 years earlier than that in females. Epidemic of CHD amoung young people should arouse our attention. Risk factors control and primary prevention will help young people especially males keep away from coronary heart disease.Objective To investigate the clinical risk factors, coronary features and the major adverse cardiovascular events(MACE) of young male patients with coronary heart disease.According to the results, we can take measures to protect young men from coronary heart disease.Methods 1.A retrospective study was conducted to analyze the clinical data of 476 male patients with CHD at our hospital between January 2011 to September 2013. They were divided into two groups according to their age.The youth group including 234 cases between 28 to 44 years old.The middle-aged and old group including 242 cases between 45 to 78 years old.2.119 cases of young men who had been provided without CHD through coronary angiography(CAG) were selected as the contrast group.3.We collected the clinical risk factors including hypertension, diabetes, dyslipidemia, the proportion of smoking and the family history of premature CHD; calculated the body mass index(BMI) through their height and weight; record the blood biochemical test result including total cholesterol, low-density- lipoprotein, High-density-lipoprotein, triglycerides, Lipoprotein(a), fasting plasma glucose and uric acid of the each group.4. We collected the coronary angiography results,the major adverse cardiovascular events during hospital and one year after discharge of the young and middleaged-and-old CHD groups.5.Analysis all the data by the software SPSS 17.Results 1. Risk factors:The proportion of patients with hypertension and diabetes mellitus in youth group with CHD is lower than those in middle-aged and old group(.P<0.01).To the contrary, the proportion of smoking, the family history of premature CHD and dyslipidemia in youth group with CHD is higher than that in middle-aged and old group(P<0.01, P<0.01, P<0.05).BMI, TG, HDL were higher(P<0.01), while TC,LDL,Lpa,UA were lower(P<0.01) in youth group with CHD than in middle-aged and old group. Proportion of diabetes mellitus, dyslipidemia,proportion of smoking,BMI and TG were higher(P<0.01),while proportion of hypertension, the family history of premature CHD,TC,LDL,HDL,LPa,UA,FBG were without significant difference(P>0.05)in youth group with CHD than in contrast group. Logistic regression analysis showed that smoking, high triglycerides, overweight or fat are independent resk factors for young male patients with CHD(P<0.01).2.Severity of coronary heart disease. The proportion of coronary artery disease related with left main coronary artery(LM), anterior descending artery(LAD,) left circumflex artery(LCX)or right coronary artery (RCA) were lower in youth group with CHD than that in middle-aged and old group(P<0.01).Culprit artery from high to low is LAD,LCX,RCA and LM in youth group with CHD while it is LAD,RCA,LCX and LM in middle-aged and old group. Anterior descending artery disease has highest ratio in two groups. Most coronary angiography results of the young male patients were single-vessel lesion of coronary.,who had lowest radio of multi-vessell disease. Most coronary angiography results of the middle-aged and old male patients were multi-vessell lesions of coronary,who had lowest radio of single-vessel disease. According to the multiple linear regression analysis,the level of BMI correlated positive with the number of the coronary lesion vessels.3. The rates of in-hospital MACE. The rate of in-hospital MACE of young male patients was 5.1%(12/234), one patient died of cardiovascular death, four patients suffered nonfatal myocardial infarction, seven patients had coronary revascularization. The rate of in-hospital MACE of middle-aged and old group was 11.2%(27/242), four patient die from cardiovascular death, seven patients suffered nonfatal myocardial infarction, fifteen patients had coronary revascularization,one patient had stroke. The rate of MACE one year after discharge. The MACE rate of one-year discharge of young male patients was 7.3%(17/233), two patients died of cardiovascular death, three patients suffered nonfatal myocardial infarction, eleven patients had coronary revascularization, one patient had stroke. The MACE rate of one-year discharge of middle-aged and old group was 14.7%(35/238), seven patients died of cardiovascular death, six patients suffered nonfatal myocardial infarction, eighteen patients had coronary revascularization, four patient had stroke.The youth group had lower rate of MACE during hospital and one year after discharge compared with the middle-aged and old group(P<0.05).Conclusion The top three risk factors for CHD of young male are smoking, high triglycerides levels, overweight or fat.Most coronary angiography results of the young male patients were single-vessel lesion of coronary, especially anterior descending artery,The level of BMI correlated positive with the number of the coronary lesion vessels.They have lower MACE rate. Control weight, stop smoking and reduce the levels of triglycerides are the most effective way to reduce the prevalence of CHD in young men.