No Traditional Risk Factors For Coronary Heart Disease Occurrence And Development Of Related Factors And Analysis Of Death-related Factors During Hospitalization Of Acute Myocardial Infarction

Objective:To explore the independent risk factors of coronary heart disease in people without traditional cardiovascular risk factors.Methods:74,612 patients underwent coronary angiography at our hospital between January 1,2013 and December 31,2013,January 1,2017 and December 31,2018.A total of 1247 patients without hypertension,diabetes,hyperlipidemia,or smoking history were included in the analysis.According to the previous medical history,coronary angiography,laboratory,and imaging examination results,they were divided into normal coronary artery group without traditional cardiovascular risk factors(normal group,N=643 cases),and coronary heart disease group without traditional cardiovascular risk factors(coronary heart disease group,N=604 cases).Collected patients' baseline data and laboratory test results,and explored independent risk factors of coronary heart disease in people without traditional cardiovascular risk factors through logistic multiple regression model.Results:The nine variables that predicted coronary heart disease in people without traditional cardiovascular risk factors were:age,sex,systolic blood pressure(SBP),percentage of neutrophils(NEU%),glycated hemoglobin(HbA1c),triglyceride(TG),Lipoprotein(a)[Lp(a)],platelets(PLT)and blood creatinine(Scr).Among them,age,male,SBP,NEU%,PLT,HbAlc,TG,Lp(a)were positively correlated with the occurrence of coronary heart disease,and Scr was negatively correlated with the occurrence of CHD(all P values<0.05).Taking coronary heart disease as a state variable and 9 relevant factors as test variables,the receiver operating characteristic curve(ROC curve)was obtained,and the area under the ROC curve(AUC)was 0.766(95%confidence interval,0.738-0.793),had good predictive value.In addition,the correlation between the above variables and the risk of coronary heart disease was not significantly different according to age,sex,and body mass index(BMI)(all interactions P>0.05).Conclusion:In addition to the traditional cardiovascular risk factors,this study found a total of 9 factors related to the risk of coronary heart disease.Clinicians should also be alert to other relevant factors that may cause coronary heart disease risk and intervene as soon as possible.Objective:To explore the independent risk factors for myocardial infarction(MI)in coronary heart disease(CHD)patients who had no traditional cardiovascular risk factors.Methods:A total of 74,612 patients underwent coronary angiography at our hospital,between January 1,2013 and December 31,2013,January 1,2017 and December 31,2018.After excluding non-CHD patients and CHD patients with hypertension,diabetes,hyperlipidemia,or smoking history,a total of 604 patients CHD without traditional risk factors were included in the analysis.According to the previous medical history,coronary angiography,laboratory and imaging findings,it was divided into non-MI group without traditional cardiovascular risk factors(non-MI group,N=479 cases);MI group without traditional cardiovascular risk factors(MI group,N=125 cases).Collected patients'baseline data,laboratory test results,and explore independent risk factors for MI in CHD population without traditional cardiovascular risk factors through logistic multiple regression model.Results:Compared with the non-MI group,there were more male patients in the MI group,more patients with previous CABG history,fewer patients with previous PCI history,and lower left ventricular ejection fraction;high-sensitivity C-reactive protein(hsCRP)and white blood cells(WBC)were higher,total cholesterol(CHO),low-density lipoprotein cholesterol(LDL-c),non-high-density lipoprotein cholesterol(non-HDL-c)were lower.Univariate logistic regression analysis P value<0.25 and 21 variables that were clinically considered to be related to myocardial infarction were included in logistic multiple regression analysis.After adjusting for confounding factors,hsCRP was positively correlated with MI without traditional cardiovascular risk factors(OR=1.139,95%CI 1.053-1.231,P=0.001),where the area under the ROC curve of hsCRP was 0.583.hsCRP had higher prediction accuracy for MI.In addition,in different age and gender subgroups,hsCRP in the myocardial infarction group tended to be higher than that in the non-myocardial infarction group,and the correlation between hsCRP and the risk of myocardial infarction was not significantly different in different age and gender subgroups(interaction P>0.05).Conclusion:This study found a positive correlation between hsCRP and the risk of MI in patients with CHD who had no traditional cardiovascular risk factors.Therefore,hsCRP may be a new risk factor for MI in CHD patients,and provide clues to prevent new targets for MI.Objective:To explore the risk factors of death in patients with acute myocardial infarction(AMI)in contemporary China.Methods:A total of 23,417 AMI patients(including 5,795 NSTEMI patients and 17,622 STEMI patients)were enrolled in the Chinese Acute Myocardial Infarction(CAMI)Registration Study from January 2013 to September 2014.1504 patients died during hospitalization,which were the hospitalized death group,and 21,913 patients who survived during the hospitalization were the hospitalized survival group.Collected patients' baseline data,clinic visits,laboratory and imaging examination results,hospital outcomes and other clinical data,and builded a logistic multiple regression model with in-hospital death as the main endpoint to explore independent risk factors for AMI patients during in-hospital death.Results:6.42%(1504/23417)of AMI patients died during hospitalization.There were significant differences in baseline data between the two groups.The death group was older,more often female,had a lower body mass index,a higher rate of cardiac arrest,a higher Killip grade,and a higher incidence of complications than those who survived.Logistic multiple regression analysis results suggested that age,gender,body mass index,systolic blood pressure,heart rate,blood creatinine level,white blood cell count,serum potassium concentration,serum sodium concentration,ST segment elevation of ECG,left ventricular anterior wall involvement,cardiac arrest,Killip cardiac function grading,hypertension,hyperlipidemia and smoking history were independent related factors for predicting death during hospitalization.Conclusion:This study found 16 independent factors related to the death of 16 contemporary Chinese patients with AMI during hospitalization,which helps clinicians to identify high-risk patients early and choose the best diagnosis and treatment strategy.