Analysis Of Characteristics Of Patients With Premature Coronary Heart Disease In Tianjin

OBJECTIVE: To select the biochemical indicators involved in the past history,family history,and routine physical examination,which are relatively easy to obtain in the clinical study,to explore the risk factors for early onset coronary heart disease compared with patients with a later onset age.The characteristics of the disease are intended to provide a reference for the early detection and prevention of coronary heart disease in young and middle-aged people.METHODS: From January 2014 to December 2017,21184 patients with coronary heart disease who underwent concurrent coronary angiography in Tianjin Chest Hospital were enrolled.All patients signed informed consent and had complete medical records.According to age,the early-onset coronary heart disease group(male onset age ?55 years old,female onset age ?65 years old)7351 cases,mean age(53.53±7.40)late-onset coronary heart disease group(male onset age>55 years old,female onset age)>65 years old)13833 cases,mean age(67.12±6.92).The patient's gender,age,history of hypertension,history of diabetes,history of cerebral infarction,and family history of coronary heart disease were collected.After admission,the venous blood was taken on an empty stomach in the morning to determine total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and apolipoprotein A(apo).A),apolipoprotein B(apo B),lipoprotein a(LPa),apolipoprotein A1/B(apo A1/B),glycated hemoglobin(HbA1c),white blood cell count(WBC),platelet count(PLT),Hemoglobin measurement(HGB),erythrocyte mean hemoglobin concentration(MCHC),erythrocyte mean hemoglobin(MCH),fibrinogen quantification(Fbg),hypersensitive CRP,glucose(Glu),B-type Lina peptide precursor(NT-pro)BNP),glutamyltranspeptidase(ALT),thrombolytic dimer(D-dimmer),creatinine(Cr),uric acid(UA),homocysteine(Hcy),etc.The Department of Clinical Laboratory of the Chest Hospital was completed.The above indexes were statistically compared between the two groups,and the relevant factors with significant differences were screened for multivariate logistic regression to screen out independent risk factors and protective factors for premature coronary heart disease.RESULTS:(1)Regardless of age,coronary heart disease was high in male patients,and the proportion of males with early-onset coronary heart disease was greater,the difference was statistically significant(P<0.05).Patients with late-onset coronary heart disease complicated with diabetes and hypertension.The proportion of history of disease and cerebral infarction was higher than that of early-onset coronary heart disease group(P<0.05),but there was no significant difference in family history of coronary heart disease between the two groups.(2)Compared with the late-onset coronary heart disease group,glycated hemoglobin,glucose,white blood cells,platelets,hemoglobin,cholesterol,triglyceride,low-density lipoprotein and serum apolipoprotein water were higher in the early-onset coronary heart disease group(P<0.05),but the levels of fibrinogen,high-density lipoprotein cholesterol,NT-pro BNP,D-dimmer,creatinine,uric acid and homocysteine were lower than those in the late-onset elderly coronary heart disease group(P<0.05).There were no significant differences in the levels of lipoprotein a and high-sensitivity CRP between the groups.(3)Multivariate regression analysis showed that men with hypertension,cerebral infarction history and elevated glycosylated hemoglobin,triglyceride,apolipoprotein,creatinine,platelet,and hemoglobin were independent risk factors for early onset coronary heart disease(P< 0.05),elevated high-density lipoprotein levels are independent protective factors for premature coronary heart disease.CONCLUSION: Men with hypertension,cerebral infarction and glycosylated hemoglobin,triglyceride,apolipoprotein,creatinine,platelet,and hemoglobin are independent risk factors for early onset coronary heart disease(P<0.05),high-density lipoprotein Elevated levels are independent protective factors for premature coronary heart disease.