| ObjectiveAtherogenic index of plasma,as a novel composite lipid index,is closely related to coronary heart disease(CAD).But blood lipid levels change with age,so it is speculated that the correlation between AIP and CAD is also influenced by age.The purpose of this study is to understand the changes in blood lipid indicators and to explore the relationship between AIP and CAD in male patients of different age groups.MethodsThis study retrospectively studied patients with suspected CAD who underwent CAG at the Second Affiliated Hospital of Anhui Medical University from January 2020 to December 2022.According to age,patients are divided into four groups:young group(≤45 years),middle-aged group(46～60 years),elderly group(61～75 years),and advanced group(>75 years).According to the results of coronary angiography,patients were further divided into CAD group and n-CAD group.Simultaneously calculate composite lipid parameters such as nonHDL-C,AI,LCI,LDL-C/HDL-C and TC/HDL-C.Evaluate the relation-ship between blood lipid parameters and CAD in patients of different age groups.Results1)Male patients were divided into four groups according to their age.The ratio of patients with CAD and hypertension increased with age,while BMI decreased with age.The rates of patients with CAD,hypertension,smoking,diabetes and BMI were significantly different among the four groups(P<0.001);TC,TG,LDL-C,VLDL,nonHDL-C,AI,LCI,LDL-C/HDL-C,AIP levels decrease with age.And the differences in TC,TG,LDL-C,VLDL,nonHDL-C,AI,LCI,LDL-C/HDL-C,AIP,HDL-C,HDL-C/TC levels among the four groups were statistically significant(P<0.01).2)According to the results of coronary angiography,male patients were divided into the n-CAD group and the CAD group.In the n-CAD group:The proportion of smoking patients and BMI decrease with age,while the proportion of hypertension patients increases with age.The proportion of smoking,hypertension,drinking patients and BMI showed significantly difference among the four groups(P<0.05).In the CAD group:the ratio of smoking patients and BMI decreased with the increase of age,and the ratio of hypertension patients increased with the increase of age.The ratio of drinking,smoking,diabetes pati-ents and BMI were statistically significant(P<0.05).3)In the n-CAD group:The levels of TC,TG,LDL-C,VLDL,nonHDL-C,LCI,AI,LDL-C/HDL-C decreased with age,while the levels of HDL-C/TC increased with age.Among them,the differences between the advanced group and the young group,as well as the advanced group and middleaged group,were statistically significant(P<0.05);The level of AIP decreases with age,and there is a statistically significant difference between the advanced group and the young group,the advanced group and the middle-aged group,and the advanced group and the elderly group(P<0.05).In the CAD group:The levels of TC,TG,LDL-C,VLDL,nonHDL-C,AI,LDL-C/HDL-C,and AIP decreased with age,while the levels of HDL-C/TC increased with age.Among them,there was a statistically significant difference between the advanced group and young group,between the advanced group and middle-aged group,and between the advanced group and elderly group(P<0.05).4)Among young patients,the levels of TC,LDL-C,nonHDL-C,AI,LCI,LDL-C/HDL-C in the CAD group were higher than those in the n-CAD group,and the levels of HDL-C/TC were lower than those in the n-CAD group.The difference were statistically significant(P<0.05).In middle-aged patients,the levels of TC,nonHDL-C,AI,LDL-C/HDL-C,and AIP in the CAD group were higher than those in the n-CAD group,while the levels of HDL-C and HDL-C/TC were lower than those in the n-CAD group.The difference were statistically significant(P<0.05).In elderly patients,the levels of TC,TG,LDL-C,VLDL,AIP,nonHDL-C,AI,LCI,LDL-C/HDL-C in the CAD group were higher than those in the nCAD group,and the levels of HDL-C/TC were lower than those in the nCAD group.The difference were statistically significant(P<0.05).In advanced patients,the levels of TC,LDL-C,nonHDL-C,AI,LCI,LDLC/HDL-C in the CAD group were higher than those in the n-CAD group,while the levels of HDL-C/TC were lower than those in the n-CAD group.The difference were statistically significant(P<0.05)5)Univariate logistic regression analysis showed that TC,LDL-C,non HDL-C,AI,LDL-C/HDL-C were risk factors for developing coronary heart disease in the young,middle-aged,and elderly groups,while HDL-C/TC was a protective factor for developing coronary heart dis-ease in the young,middle-aged,and elderly groups.TG and VLDL are risk factors for coronary heart disease in elderly patients,HDL-C is a protective factor for coronary heart disease in middle-aged pati-ents,and AIP is a risk factor for coronary heart disease in middle-aged and elderly patients(P<0.05).6)Multivariate logistic regression analysis showed that TC,LDL-C,HDL-C/TC,nonHDL-C,and AI were independent risk factors for coronary heart disease in young patients,while LDL-C/HDL-C was an independent protective factor for coronary heart disease in young patients.TC,LDL-C,nonHDL-C,AI,LDL-C/HDL-C are independent risk factors for coronary heart disease in middle-aged patients,while HDL-C and HDLC/TC are independent protective factors for coronary heart disease in middle-aged patients.TC,TG,LDL-C,VLDL,nonHDL-C,AI,LCI,LDLC/HDL-C,AIP are independent risk factors for coronary heart disease in elderly patients,while HDL-C/TC is an independent protective factor for coronary heart disease in elderly patients.ConclusionBlood lipid indicators that considered as risk factors for coronary heart disease,decrease with the age of male patients.The CAD group showed a more significant decrease compared to the n-CAD group.AIP and other blood lipid indicators are influenced by age in predicting the risk of male coronary heart disease.AIP is an independent risk factor for coronary heart disease in elderly patients.All blood lipid indicators are not independent risk factors for coronary heart disease in advanced patients.ObjectiveThe pathophysiological mechanism of slow coronary flow has not been fully elucidated.More and more evidences indicate that Atherosclerosis plays a potential role in the pathophysiology of CSF.The purpose of this study is to explore the relationship between plasma atherogenic index(AIP)and CSF.MethodsThis article adopts a retrospective research method.We collect case data of patients undergoing CAG examination at the Second Affiliated Hospital of Anhui Medical University from January 2020 to December 2022 for research.According to the inclusion and exclusion criteria,145 patients with CSF were selected as the study subjects,while 145 patients with normal coronary blood flow were selected as the control group.We record case information,laboratory examination data and so on of two groups of patients.Then we conducted logistic regression analysis on meaningful indicators between two groups,screened independent influencing factors,plotted subject work characteristic curves,calculated the area under the curve,and evaluated the predictive value of risk factors.Results1)The average ages of the two groups of patients were respectively 55.02±9.63 years and 54.82±8.67 years.Both groups of patients showed a male advantage,with 80%in the CSF group and 55.8%in the NCF group.The proportion of males and smokers in the CSF group is significantly higher than that in the NCF group,the NLR,PLR,white blood cells,neutrophils,platelets,LDL-C,TG,non HDL-C,AIP,non HDL-C/HDL-C,TC/HDL-C,and LDL-C values in the CSF group were all higher than those in the NCF group,the HDL-C and lymphocytes in the CSF group were significantly lower than those in the NCF group,the differences between groups were statistically significant(P<0.05)2)The comparison of TIMI frames of coronary blood flow between two groups of patients shows that:The number of LAD blood flow frames in the CSF group(45.2±6.5)was significantly higher than that in the NCF group(21.3±2.0);The corrected blood flow frame number(29.7±3.9)in the CSF group was significantly higher than that in the NCF group(14.4±1.3);The number of LCX blood flow frames in the CSF group(28.4±3.5)was significantly higher than that in the NCF group(13.5±1.8);The number of RCA blood flow frames in the CSF group(30.6±4.5)was significantly higher than that in the NCF group(14.7±1.5);The average blood flow frames in the CSF group(32.2±2.7)were significantly higher than those in the NCF group(15.5±1.4);In addition,73%of patients with CSF occur in LAD,31%in LCX,and 51%in RCA.3)Single factor logistic regression analysis shows that:Male,smoking,platelets,NLR,PLR,TG,LDL-C,nonHDL-C,AIP,TC/HDL-C,LDLC/HDL-C and nonHDL-C/HDL-C are risk factors for CSF,while HDL-C is a protective factor for CSF(P<0.05).Multivariate logistic regression analysis shows that:Smoking(OR,3.073;95%CI,1.774-5.768;P<0.001),men(OR,3.052;95%CI,1.789-6.923;P<0.001),AIP(OR,3.172:95%CI,1.345-12.986;P=0.001)and LDL-C/HDL-C(OR,1.653;95%CI,1.115-2.247;P=0.005)are independent predi-ctors of CSF.The analysis of the subject’s work characteristic curve shows that:The optimal cutoff value for predicting CSF by AIP is 0.42(sensitivity 76%;specificity 57%;AUC 0.71;P<0.001).The opt-imal cutoff value for predicting CSF by LDL-C/HDL-C is 3.38(sensitivity 58%;specificity 77%;AUC 0.71;P<0.001).ConclusionMale,smoking,AIP,and LDL-C/HDL-C are independent predictors of coronary slow blood flow.AIP and LDL-C/HDL-C are considered good indicators for predicting coronary heart disease,and also have certain value in predicting CSF.Atherosclerosis may play a role in the pathophysiological process of CSF. |
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