Risk Factors And Characteristic Of Coronary Artery Lesions In Premenopausal And Postmenopausal Women With Coronary Heart Disease

Objective: In recent years, along with the social progress and economicdevelopment, cardiovascular disease(CVD)，especially the coronary heartdisease (CHD) has became one of the biggest threat to human health. Previousstudies have been that elderly and men have more dangerous on CHD. Womenin low-risk of CHD with the protection of estrogen have tended to overlookthe study of female CHD. Epidemiological data have confirmed that themorbidity of CHD in premenopausal women with CHD was lower than men,but it didn’t mean that premenopausal women were not happen in CHD, so wecan’t ignore the dramatic increase in incidence of postmenopausal women withCHD. During the cause of death in Chinese women, CHD has exceeded thestroke and cancer, became the first cause of death. This study aimed toanalysis the relationship between risk factors and characteristic of coronaryartery lesions in premenopausal and postmenopausal women with CHD, raisedtheir awareness of women CHD and controlled risk factors of comprehensive,provided theoretical basis for taking comprehensive and effective earlyintervention for clinical treatment.Methods: Collected214cases patients of women CHD with angiographyexamination from June2010to October2013in cardiovascular internalmedicine1of the3th Hospital of Hebei Medical University. According towhether patients menopause, divided into premenopausal group (Group A,n=68) and postmenopausal group (Group B, n=146). Collected the generalinformation of CHD risk factors, such as age, family history of CHD, historyof Hypertension, history of Diabetes Mellitus, White blood cell (WBC) count,proportion of Neutrophil(NE%), Red Blood Cell (RBC) count,Hemoglobin(HGB) level, Total Bilirubin (TIL)level, Total Cholesterol(TC) level, Triglycerides(TG) level, High-Density Lipoprotein Cholesterol(HDL-C)level, Low-Density Lipoprotein Cholesterol(LDL-C) level, Lipoprotein(a)(Lp(a)) level, Uric Acid(UA) level, Fibrinogen (FIB) level. Genisin score werecombined with coronary angiography result and accorded to the characteristicsof coronary arteries lesions. Retrospective analyze the risk factors andcharacteristics of coronary artery lesions in premenopausal andpostmenopausal women with CHD.Results:1Risk factors of CHD:Family history of CHD was the main risk factor ofpremenopausal women with CHD, there was some significant differences init(P<0.05). History of Hypertension, history of Diabetes Mellitus, history ofWhite Blood Cell (WBC)count, Uric Acid(UA) level, Fibrinogen(FIB) levelwere the main risk factors of postmenopausal women with CHD, there weresome significant differences in them(P<0.05). Red Blood Cell(RBC) count,Direct Bilirubin (DIL) level, High-Density Lipoprotein Cholesterol(LDL-C)level of premenopausal group with CHD were higher than postmenopausalgroup with CHD, there were neither any significant differences inthem(P>0.05). Proportion of Neutrophil(NE%), Hemoglobin(HGB) level,Indirect Bilirubin(BIL) level, Total Cholesterol(TC) level, Triglyceride(TG)level, Low-Density Lipoprotein Cholesterol(LDL-C) level,Lipoprotein(a)(Lp(a)) level of premenopausal group with CHD were lower than inpostmenopausal group with CHD, there were neither any significantdifferences in them(P>0.05).2Coronary artery lesion characteristics: The proportion of single lesionwas higher in premenopausal group with CHD, there were some significantdifferences in them(P<0.0001), The proportion of double lesions and threelesions was lower in premenopausal group with CHD,there were somesignificant differences in them(P<0.05). Left Main(LM) lesion of proportionin premenopausal group with CHD was higher than postmenopausal groupwith CHD, but there was neither any significant differences init(P>0.05).During the lesions vessels of women patients with CHD,Left Anterior Descending artery (LAD) was the most easily effected, the secondwas Right Coronary Artery(RCA), the third was Left Circumflexartery(LCX). The proportion of LAD lesion in premenopausal group withCHD was less than postmenopausal group with CHD, there was neither anysignificant differences in it(P>0.05).The proportion of LCX,RCA lesionsin premenopausal group with CHD were obvious less than postmenopausalgroup with CHD, there were some significant differences in them(P<0.05).3Type of CHD: The proportion of stable angina pectoris(SAP) inpremenopausal group with CHD was higher than postmenopausal group withCHD, there was some significant differences in it(P<0.05). The proportion ofunstable angina pectoris(UAP) in premenopausal group with CHD waslower than postmenopausal group with CHD, there was neither any significantdifferences in it(P>0.05). The proportion of Myocardial Infarction(MI) inpremenopausal group with CHD was lower than postmenopausal group withCHD, there was some significant differences in it(P<0.05). The proportionof Myocardial Infarction(MI) with Heart Failure(HF) in premenopausal groupwith CHD was obvious lower than postmenopausal group with CHD, therewas some significant differences in it(P<0.05). During the premenopausalgroup with CHD, SAP was the most common, the second was UAP, and thethird was MI. During the postmenopausal group with CHD, MI was the mostcommon, the second was UAP, and the third was SAP.4Genisin score: The Genisin score of group1proportion inpremenopausal group with CHD was higher than postmenopausal group withCHD, there was some significant differences in it(P<0.05). The Genisin scoreof group2proportion in premenopausal group with CHD was higher thanpostmenopausal group with CHD, there was neither any significant differencesin it(P>0.05). The Genisin score of group3and5proportion in premenopausalgroup with CHD was lower than postmenopausal group with CHD, there wasneither any significant differences in it(P>0.05). The Genisin score of group4proportion in premenopausal group with CHD was higher thanpostmenopausal group with CHD, there was some significant differences in it(P<0.05).5The relativity of risk factors and characteristic of coronary arterylesions of women patients with CHD: Age, history of Hypertension, historyof Diabetes Mellitus were closely relative to the degree of coronary arterystenosis of premenopausal women with CHD(P<0.05). Total Cholesterol(TC), Low-Density Lipoprotein Cholesterol (LDL-C) level, Fibrinogen (FIB)level were closely relative to the lesions count of premenopausal women withCHD.Conclusion:1Family history of CHD was the main risk of premenopausal womenwith CHD，history of Hypertension, history of Diabetes Mellitus, WhiteBlood Cell(WBC) count, Uric Acid(UA) level, Fibrinogen(FIB) level were themain risk of postmenopausal women with CHD.2Premenopausal group was given priority to with single lesion, and leftanterior descending (LAD) was the most easily affected, involvement of theLeft Main (LM) proportion was also.3During the type of CHD in premenopausal group with CHD, SAP wasthe most common, the second was UAP, and the third was MI，the MI with HFproportion was less.4The degree of coronary artery stenos is of premenopausal group withCHD was lesser, the Genisin score was lower, and on the whole, the coronaryartery lesion of premenopausal women with CHD was lighter than thepostmenopausal women with CHD.5Age, history of Hypertension, history of Diabetes Mellitus were closelyrelative to the degree of coronary artery stenosis of premenopausal womenwith CHD. Total Cholesterol (TC), Low-Density Lipoprotein Cholesterol(LDL-C) level, Fibrinogen (FIB) level were closely relative to the lesionscount of premenopausal women with CHD.