Gender Difference Of Distribution And Clustering Status Of The Risk Factors Premature Severe Three-vessel Coronary Disease

Object i ve:In recent years, incidence of coronary heart disease (CHD) tends younger age. Premature Coronary Artery Disease (PCAD) as a special group of coronary heart disease bring a very serious harm to the social. But studies about epidemiological characteristic of conventional risk factors of premature severe three-vessel coronary artery lesions were fewer.This study is to analyze the gender differences of contribution and clustering of the risk factors for the premature severe three-vessel coronary artery lesions, and to provide the evidence for prevention of the PCAD patients.Methods:Consecutive cases of hospitalized patients with chest pain or suspected coronary artery were collected at the Second Hospital of Tianjin Medical University during March2009to March2012. All patients accepted coronary angiography. The criteria for premature severe three-vessel coronary artery lesions group as follows:(1) according to quantitative coronary angiography. severe three-vessel coronary artery lesions indicates the area stenosis of LAD, LCX, RCA or LM, RCA is more than75percent;(2) the onset age of CHD is less than55years old for male and65years old for female; The criteria for normal coronary angiography is that three coronary arteries are smooth;285cases for premature severe three-vessel coronary artery lesions and114cases for normal coronarography were selected. Medical history including gender, age, smoking, hypertention, diabetes mellitus (DM), positive family history (PFH) of CHD and so on were taken for all these patients. Routine blood cell test, renal functions and so on were measured at the moment of admission. At the next morning peripheral venous blood was taken for the measurement of blood lipids, liver function, CRP and so on. Routine examination of the echocardiography was performed.Results:(1) The CHD group of female had higher ratios of hypertension, DM, PFH, metabolic syndrome, obesity and higher levels of triglyceride, low-density-lipoprotein-cholesterol(LDL-C), BMI, WBC and CRP,but lower levels of high-density-lipoprotein-cholesterol(HDL-C)(P<0.05). Multiple logistic regression analysis showed that PFH, DM, obesity, low HDL-cholesterolemia, high LDL-cholesterolemia and hypertriglyceridemia were significantly associated with premature severe three-vessel coronary lesions.(2) The CHD group of male had higher ratios of hypertension, DM, PFH, metabolic syndrome, smoking, obesity and higher levels of triglyceride, low-density-lipoprotein-cholesterol(LDL-C), very low-density-lipoprotein-cholesterol(VLDL-C), fibrinogen,BMI, WBC, and CRP,but lower levels of high-density-lipoprotein-cholesterol(HDL-C)(P<0.05). Multiple logistic regression analysis showed that smoking, PFH, DM, low HDL-cholesterolemia and high LDL-cholesterolemia were significantly associated with premature severe three-vessel coronary lesions.(3) Comparion of risk factors for two genders in the disease group showed that the ratios of smoking and low HDL-cholesterolemia were higher in male disease group and the ratios of high LDL-cholesterolemia, obesity and hypertriglyceridemia were higher in female disease groups(P<0.05).The proportion of risk factor number above three in male disease group was higher than female disease group(74.2%vs54.4%).(4) Left ventricular function between disease group of genders was no significance.Conelusion:(1) Risk factors were significantly different between two genders. PFH, DM, obesity, low HDL-cholesterolemia, high HDL-cholesterolemia and hypertriglyceridemia were independent risk factors for female premature severe three-vessel coronary artery lesions. Smoking, PFH, DM, low HDL-cholesterolemia and high LDL-cholesterolemia were independent risk factors for male premature severe three-vessel coronary artery lesions.(2) The clustering extent of risk factors was higher in male group.(3) Left ventricular function between disease group of genders was no significance.