Analysis Of Clinical Characteristics And Coronary Artery Lesions In Patients With Premature Coronary Heart Disease

Objective:Through the comparative analysis of the clinical characteristics of patients with coronary heart disease,to explore the clinical characteristics coronary heart disease in patients with premature coronary heart disease,so as to provide clinical reference for the prevention and treatment of premature coronary heart disease.Methods:A total of 694 patients with chest tightness,chest pain treated with coronary angiography in the cardiovascular department of the Affiliated Hospital of Zunyi Medical University from September 2018 to March 2019 were collected.Among which there were266 patients with premature coronary heart disease(167 males,99 females,male onset age≤55,female onset age ≤65),297 patients with non-premature coronary heart disease(204 males,93 females,male onset age >55,female onset age >65),and 131 normal patients in controls(63 males and 68 females).The basic information of the patients was recorded,the blood routine and biochemical indexes were collected,the location and number of diseased vessels were recorded,the Gensini score was calculated,and the risk factors of premature coronary heart disease and the characteristics of coronary artery lesions were statistically analyzed.Results:1.Comparison of clinical characteristics among the three groups: compared with the normal control group,the average age,admission systolic blood pressure,WBC,RBC,fibrinogen,apolipoprotein B/A1,creatinine and cystatin C increased in the non-premature coronary heart disease group.Compared with the normal control group,there was mostly male in the premature coronary heart disease group,and hypertension,diabetes,smoking,age and obesity were all risk factors.WBC,platelet,fibrinogen,triglyceride,total cholesterol,high density lipoprotein,low density lipoprotein,residual cholesterol,apolipoprotein A1,apolipoprotein B,apolipoprotein B/A1 and creatinine were higher.Compared with the non-premature coronary heart disease group,WBC,RBC,hemoglobin,platelet,triglyceride,high density lipoprotein,residual cholesterol,apolipoprotein A1,apolipoprotein B,creatinine,cystatin C,body weight,admission diastolic blood pressure and BMI were higher in the premature coronary heart disease group.2.Risk factor analysis:(1)Compared with the normal control group,hypertension(OR=3.117,95%CI: 1.779 ～ 5.461),diabetes(OR=8.814,95%CI: 1.937 ～ 40.105),smoking(OR=1.937,95%CI: 1.104～3.397),WBC(OR=1.445,95%CI: 1.258～1.659),fibrinogen(OR=1.622,95%CI: 1.079～2.437)and apolipoprotein B/A1 ratio(OR=5.182,95%CI: 1.293～20.775)were independent risk factors of premature coronary heart disease(P < 0.05).(2)Compared with non-premature coronary heart disease,high density lipoprotein(OR=0.358,95%CI: 0.167 ～ 0.764)and cystatin C(OR=0.037,95%CI:0.013 ～ 0.107)were protective factors of premature coronary heart disease(P < 0.05),RBC(OR=1.79,95%CI: 1.274～2.514),platelet(OR=1.004,95%CI: 1.001～1.007)and BMI(OR=1.104,95%CI: 1.04 ～ 1.173)were risk factors of premature coronary heart disease(P < 0.05).3.Comparison of incidence and characteristics of coronary artery lesions between patients with premature coronary heart disease and patients with non-premature coronary heart disease: the onset of ACS(65.8% VS 56.6%)was more common in the premature coronary heart disease group,and SAP(34.2% VS 43.4%)was more common in the non-premature coronary heart disease group(P < 0.05).Single-vessel disease was more common in premature coronary heart disease(47.4% VS 35%)(P < 0.05),and multi-vessel disease was more common in non-premature coronary heart disease group(25.2% VS 34%)(P < 0.05).There was no significant difference in the location of diseased vessels and Gensini score between the premature and non-premature coronary heart disease groups(P > 0.05).4.In patients with coronary heart disease,the level of apolipoprotein B/A1 in single-vessel disease group(0.67 ± 0.193)was significantly lower than that in two-vessel disease group(0.76 ± 0.499)and multi-vessel disease group(0.75 ± 0.244)(P < 0.05),but there was no significant difference between two-vessel disease group(0.76 ± 0.499)and multi-vessel disease group(0.75 ± 0.244)(P > 0.05).There was no significant difference in residual cholesterol among different diseased vessels(P > 0.05).Conclusion:1.Hypertension,diabetes,smoking,WBC,fibrinogen and increased apolipoprotein B/A1 ratio are independent risk factors of premature coronary heart disease.2.Compared with the non-premature coronary heart disease group,the increase of RBC,platelet and BMI are the risk factors of premature coronary heart disease,while high density lipoprotein and cystatin C were the protective factors of premature coronary heart disease.3.Patients with premature coronary heart disease often start with ACS,and single-vessel disease is more common,while patients with non-premature coronary heart disease often start with SAP,and multi-vessel disease is more common.4.The level of apolipoprotein B/A1 ratio in single-vessel disease group is lower than that in two-vessel disease group and multi-vessel disease group.