The Analysis For The Characteristics And Risk Of Coronary Myocardial Bridging And The Evaluation For The Role Of Hs-CRP Between Myocardial Bridging And Coronary Artery Lesion

Objective:The objective of the study is to analyse the clinical characteristics as well as the coronary angiographic features of the patients with myocardial bridging(MB),evaluate the risk of MB for the coronary diseases,proceed the Logistic analysis including MB and other risk factors for coronary diseases,assess the correlation between coronary angiographic features of MB and cardiac events,and also explore the role and significance of hs-CRP for MB and cardiac events.Methods:We enrolled 474 patients and divided them into myocardial bridging(MB) group(n=330) and non-MB group(n=144) according to coronary angiographic results.We studied the clinical features and angiographic findings of MB patients by means of univariate analysis.We excluded 18 patients for incomplete datas,and divided the rest 456 patients,according to the angiographic results,into non-lesion group(n=163),one-lesion group(n=107),two-lesion group(n=82),and three-and-above lesion group(n=104).We grouped 115 patients into lesion-proximal-to-MB-in-LAD group and non-lesion-proximal-to-MB-in-LAD group for the sake of atherosclerosis degree there.Logistic analysis was made,including MB and other risk factors,to evaluate the risk of MB for its proximal lesion.Also,we divided 250 patients into myocardial infaction(MI) group and non-MI group,and assessed the risk of MB and other factors for MI.We measured mural coronary artery (MC) length,MC reference diameter(MC-RD),MC compression diameter(MC-CD), compression ratio of diameter(CR-diam),and compression ratio of area(CR-area) in 298 patients of atypical group(n=90),stable angina group(n=58),unstable angina group(n=77),acute myocardial infarction group(n=45),and others(n=28) excluding 32.We used ranksum test to make the evaluation between angiographic measurements with cardiac events.266 patients were detected high sensitivity C-reactive protein(hs-CRP) and were divided into MB group(n=210) and non-MB group(n=56). 210 patients were further subgrouped into lesion-proximal-to-MB group(n=113) and non-lesion-proximal-to-MB group(n=97).These 113 patients were divided into atypical group(n=6),stable angina group(n=14),unstable angina group(n=14),acute myocardial infarction group(n=18),and others(n=61).Results:The univariate analysis showed that the patients with MB were younger than non-MB(P＜0.001),and possessed higher diastolic pressure(P0.030), fewer diabetes(P＜0.001),especially fasting blood glucose(P＜0.001) and 2-hour postprandial blood glucose(P=0.025),higher HDL-ch(P=0.031) and Apo-A(P=0.024), lower BUN(P＜0.001),Scr(P＜0.001) and NT-proBNP(P=0.002),and higher hs-CRP(P=0.048).And about coronary angiographic features,MB group owned more patients with non-lesion(P＜0.001) and one-lesion(P＜0.001),while fewer with two-lesion(P＜0.001) and three-and-above-lesion(P＜0.001).Logistic analysis showed that the number of coronary arterial lesions is the independent risk factor for lesion in LAD,and its odds ratio(OR) is 4.046.CRP is the independent risk factor for the occurrence of myocardial infarction,and its OR is 1.035.MB has no significant influence on the occurrence of lesion proximal to MB in LAD as well as MI.The measurements of AMI group,MC-CD,CR-diam,CR-area,were higher than those of unstable angina group(P=0.009,0.006,0.007).MB group has higher hs-CRP than non-MB(P=0.048).There was no significant difference between lesion-proximal-to-MB and non-lesion-proximal-to-MB in LAD(P=0.893).We analyzed the relation between hs-CRP and the clinical cardiac events induced by lesion proximal to MB,and we found that AMI patients have much higher hs-CRP than other patients.Conclusion:The number of coronary arterial lesions is the independent risk factor for lesion in LAD.CRP is the independent risk factor for the occurrence of myocardial infarction.MB has no significant influence on the occurrence of lesion proximal to MB in LAD as well as MI.The length of MCA has no correlation with cardiac events,but its compression degree has significant difference in different events.CRP in patients with MB is higher than non-MB.But there is no significant difference if there is lesion proximal to MB in LAD.AMI patients have much higher hs-CRP than others,and there is correlation between hs-CRP and events induced by the lesion proximal to MB.