Study On The Risk Factors Of Patients With Premature Coronary Artery Disease And The Clinical Value Of Different Risk Factors In Predicting The Severity Of Coronary Artery Disease

Objectives:Patients with coronary artery heart disease(CHD)are getting younger and younger,and the incidence of premature coronary artery disease(PCAD)is increasing,which has a far-reaching adverse impact on patients.Therefore,effective prevention of its incidence has important clinical significance.By analyzing the clinical characteristics of patients with CHD in different age groups,this study aims to explore the risk factors of patients with PCDA and the clinical value of predicting the severity of PCDA based on different risk factors,in order to provide clinical reference for the prevention and treatment of PCDA.Methods:A retrospective cohort study was designed to include hospitalized patients(male<55 years old,female<65 years old)diagnosed with CHD by clinical symptoms and coronary angiography(CAG)admitted to the Department of Cardiology,the Nanchong Fifth People’s Hospital,Sichuan Province including clinical statistic,survival datas,and CAG results.According to the relationship between the predicted model score and the probability of risk score,the risk of severe coronary artery disease was predicted as low risk group(score of-2 to 5),moderate risk group(score of 6 to 8)and high risk group(score of 9 to 15).The receiver operating characteristic curve(ROC)-was used to determine the area under the ROC curve(AUC)of the scoring model for predicting the severity of coronary artery in patients with PCHD.The calibration ability of the prediction model was tested by Hosmer-Lemeshow goodness of fit test.Results:A total of 264 patients(138 males and 126 females)with CHD were enrolled in this study,with an average age of(53.71±8.90)years.Among them,166 patients(62.88%)had body mass index(BMI)≤24 kg/m2,and 98 patients(37.12%)had BMI>24 kg/m2.98 cases(37.12%)had smoking history;history of hypertension in 128 cases(48.48%);218 cases(82.58%)had a history of diabetes;131 cases(49.62%)had a history of hyperlipidemia.The results of coronary angiography showed that coronary artery lesions in patients with PCAD were mainly single vessel disease.Among them,118 patients with single coronary artery disease,accounting for 44.70%of the total population;56 patients with double coronary artery disease,accounting for 21.21%of the total population;in the trunk,three or more coronary artery disease in 90 patients,accounting for 34.09%of the total population.In patients with PCAD,single-vessel coronary artery disease group,double-vessel coronary artery disease group and main coronary artery disease group,three or more coronary artery disease group,different risk factors and clinical test results were compared by one-way analysis of variance.The results showed that there were statistically significant differences in gender,smoking history,history of diabetes,blood pressure,heart rate,cTnT,BNP,triglyceride-glucose index,low-density lipoprotein,lipoprotein a,uric acid,urea nitrogen,creatinine,hematocrit,CRP and ST segment changes in electrocardiogram.Patients with PCAD in single-vessel coronary artery disease group,double-vessel coronary artery disease group and the main,three or more coronary artery disease group between the three groups of different risk factors and clinical test results were compared by multivariate analysis of variance,the results showed that:in gender,history of diabetes,heart rate,blood pressure,cTnT,hematocrit,CRP,ECG ST segment changes with statistical difference.According to the corresponding relationship between the prediction model score and the probability of risk score,when the score is-2 to 5 points,the probability of severe coronary artery disease is 0.001%to 1.654%,and the risk of severe coronary artery disease is predicted to be low.When the patient score was 6 to 8 points,the probability of severe coronary artery disease was 4.504%to 27.051%,and the risk of predicting severe coronary artery disease was moderate.When the score was 9 to 15 points,the probability of severe coronary artery disease was 50.975%to 99.803%,and the risk of predicting severe coronary artery disease was high.ROC curve analysis was performed on the scoring model for predicting the severity of coronary artery in patients with PC AD.The AUCe was 0.847,and the 95%CI was 0.802 to 0.892.suggesting that the difference between the predicted value of the model and the observed value of the actual study was not statistically significant.The prediction model has a better calibration ability.Conclusion:The main results are as follows:BMI,smoking history,diabetes history,hyperlipidemia history are risk factors for PCAD.PCAD is associated with changes in blood pressure,heart rate,cTnT,BNP,triglyceride-glucose index,low-density lipoprotein,lipoprotein a,uric acid,urea nitrogen,creatinine,hematocrit,CRP,and electrocardiogram ST segment.Coronary artery disease in patients with premature coronary heart disease is single vessel disease.ROC curve analysis was performed based on the scoring model for predicting the severity of coronary artery in patients with PCAD.The ROC curve area was the largest and the prediction model was highly identifiable.Scoring model based on the severity of coronary artery in patients with PCAD has better calibration ability.