Characteristics Of Coronary Artery Lesions In Patients With Coronary Heart Disease With Different Body Mass Index

Objective:To investigate the characteristics of coronary artery lesions in patients with coronary heart disease(CHD)with different body mass index(BMI),and to provide the basis for clinical precise intervention.Methods:546 patients with coronary heart disease diagnosed by selective coronary angiography were selected from Jan.2019 to Jun.2020 in the Department of cardiovascular medicine of a tertiary hospital in Qiqihar city.All patients met the inclusion criteria.General information(name,gender,age,smoking history,drinking history,height,weight,blood pressure,etc.)of patients were collected;biochemical data(fasting blood glucose,glycosylated hemoglobin,TC,TG,LDL-C,HDL-C,etc.);coronary angiography data(number,location and stenosis of coronary artery lesions)Degree,etc.).The general data,biochemical indexes,clinical types,coronary angiography results(index and degree)of the patients in each group were analyzed and compared according to the adult BMI grouping standard formulated by the Chinese obesity working group in 2002.The degree of stenosis was analyzed by Gensini score,and the patients were divided into groups according to the Gensini total score of coronary lesions,and different coronary lesions were analyzed The score group was stratified by different BMI index,and the different characteristics of patients were analyzed.Results:1.The general data:368 patients were male,accounting for 67.40%;178 patients were female,accounting for 33.60%among 546 patients with coronary heart disease.The average age was(62.18±10.37)years.BMI was16.90～35.71,with an average of(24.48±2.86);Gensini score was 14.00-98.00,with an average of(56.34±4.23).2.The BMI grouping:BMI<18.5kg/m~2accounted for 1.47%,18.5kg/m~2≤BMI<24.0kg/m~2accounted for 41.58%,24.0kg/m~2≤BMI<28.0kg/m~2accounted for48.35%,BMI≥28.0kg/m~2accounted for 8.61%in the selected patients with coronary heart disease.3.Comparison of Gensini score of coronary artery in different BMI groups:There were significant differences in Gensini scores among patients with different BMI,BMI<18.5kg/m~2have different Gensini scores,The Gensini score was mainly≤30 points;the Gensini score was mainly 31-60 points for coronary heart disease patients with 18.5kg/m~2≤BMI<24.0kg/m~2;the Gensini score was mainly 31-60points for coronary heart disease patients with 24.0kg/m~2≤BMI<28.0kg/m~2;the Gensini score was mainly>60 points for coronary heart disease patients with BMI≥28.0kg/m~2among which patients with.4.Comparison of the number of diseased coronary arteries in patients with coronary heart disease of different BMI:There were significant differences in the number of coronary artery lesions among patients with different BMI.The lesion is mainly single vessel for patients with coronary heart disease of BMI<18.5kg/m~2.The lesion is mainly double vessel for patients with coronary heart disease of<18.5kg/m~2BMI≤24.0kg/m~2,24.0kg/m~2≤BMI<28.0kg/m~2.The lesion is mainly multiple vessel for patients with coronary heart disease with BMI≥28.0kg/m~2.5.Comparison of the location of coronary artery lesions in patients with coronary heart disease with different BMI:There were significant differences in the location of different lesions in patients with coronary heart disease with BMI.There was no statistical significance for main lesion site in patients with coronary heart disease with BMI<18.5kg/m~2;The LAD was the main lesion site in patients with coronary heart disease with18.5kg/㎡≤BMI<24.0kg/㎡,24.0kg/㎡≤BMI<28.0kg/㎡and BMI≥28.0kg/㎡.6.Comparison of coronary artery stenosis in coronary heart disease patients with different BMI:There was significant difference in stenosis of coronary heart disease patients with different BMI.The Coronary artery stenosis of the patients with BMI<18.5kg/m~2,18.5kg/㎡≤BMI<24.0kg/㎡,24.0kg/㎡≤BMI<28.0kg/㎡和BMI≥28.0kg/㎡was mainly 51-75%.7.Comparison of different types of coronary heart disease in patients with different BMI:There were significant differences in different types of coronary heart disease in patients with different BMI.The unstable angina pectoris was the main type of coronary heart disease in patients with BMI<18.5kg/m~2,BMI 18.5kg/m~2≤BMI<24.0kg/m~2,24.0kg/m~2≤BMI<28.0kg/m~2and BMI≥28.0kg/m~2.8.Comparison of blood lipid and blood glucose in patients with different BMI:The difference of the level of total cholesterol,triglyceride,HDL and LDL in different BMI patients was statistically significant(P<0.001).The difference of the fasting blood glucose level of coronary heart disease patients with different BMI was not statistically significant(P>0.05).9.Comparison of echocardiography in coronary heart disease patients with different BMI:There was no significant differences in aortic root diameter,left atrial anteroposterior diameter,left ventricular end diastolic diameter,right ventricular anteroposterior diameter,pulmonary artery trunk diameter,right atrial transverse diameter,mitral valve e peak,mitral valve a peak,aortic Vmax,pulmonary artery Vmax,left ventricular ejection fraction decreased ventricular septal thickness and left ventricular posterior wall thickness decreased with the increase.10.Comparison of MACE in patients with coronary heart disease in different BMI groups:The difference for MACE in patients with coronary heart disease in different BMI was statistically significant(P=0.001).The difference for cardiac death,revascularization,stroke in patients with coronary heart disease in different BMI was not statistically significant(P>0.05).The differences of non fatal myocardial infarction,recurrent angina pectoris,recurrent failure and arrhythmia in patients with coronary heart disease with different BMI were statistically significant,and the incidence increased with the increase of BMI.Conclusion:1.The BMI can reflect the severity of coronary artery disease in patients with coronary heart disease to a certain extent.2.The Gensini score of coronary artery in patients with coronary heart disease increased with the increase of BMI.The lesions were mainly involved in two or more vessels.The LAD lesions increased,and the degree of coronary artery stenosis increased.The types of coronary heart disease and cardiac function were different with the different BMI.3.The cardiac function of CHD patients is no change with the change of different BMI,but the incidence of mace in CHD patients with different BMI patients is different.