| Backgroound Since1948, the famous Framingham Heart Study put forward the concept of the risk factors of cardiovascular disease, a series of large-scale clinical prospective researches such as the Seven Countries Study, The Multiple Risk Factor Intervention Study (MRFIT) and The Munster Heart Study(PROCAM) confirmed that the CHD is caused by a number of risk factors. At present, more than300risk factors have been confirmed, they are divided into invariable factors (such as age, sex, socioeconomic status, cardiovascular disease, family history) and variable factors (such as hypertension, high cholesterol, smoking, lack of physical exercise, diet, etc.)Now, the risk factors of coronary disease have been more comprehensive and profound understanding, but the linkages between the multiple risk factors have not gotten adequate research. The correlation between the degree of quantity lack of analysis, as well the use of coronary artery stenosis score to assess the risk factors. This study is a retrospective analysis, by collecting nearly2,000samples of patients undergoing coronary angiography in Nanjing, we firstly compare the six major coronary heart disease risk factors of gender, age, smoking, hypertension, high cholesterol, diabetes, and then analysis the law of coronary lesions combined with the Gensini scores, at last we concluded the qualitative and quantitative results of various risk factors impacted on the Chinese CHD. The results of this study will help us make a more comprehensive understanding of the characteristics of the coronary disease risk factors in Chinese patients, it has important clinical significance on building the prevention and treatment strategies of coronary heart disease.Objective1) to explore the risk factors of coronary heart disease and the relationship between the various risk factors and coronary heart disease in Chinese people.2) to analysis of the relationship between the six main risk factors of gender, age, smoking, hypertension, high cholesterol, diabetes and the law of coronary artery disease.3) to study the relationship between the above risk factors and the severity of coronary lesions in CHD patients from different age groups.Methods1) to collect1908cases of the patients suspected with coronary artery disease undergoing coronary angiography at the General Hospital of Nanjing Military, the samples are divided into coronary heart disease (1346cases), non-CAD group (562cases) according to the coronary angiography results, compare the basic information of the two groups. And then analysis the relationship between the risk factors and the coronary disease through logistic regression analysis.2) to group the CHD patients by six major risk factors of sex, age, smoking, hypertension, high cholesterol, diabetes grouping, compare the number of vessels, LM occlusion rate, complete occlusion rate and Gensini scores between the two groups.3) to group the above risk factors by age, analysis the impact of various risk factors on the severity of coronary lesions of different age groups.Results1) In CHD patients, men have980cases, the average age is64.06years old,595cases of smokers of smoking,262cases of obesity,282cases of hypercholesterolemia,139cases of LCL-C,304cases of low HDL-C,278cases of diabetes,909cases of hypertension,176cases of anemia; In addition of anemia, other indicators compared with non-CAD group are statistically significant (P<0.05). The most significant independent risk factor of Chinese coronary heart disease is diabetes, followed by smoking, high LDL-C, by age, gender, hypercholesterolemia, obesity, low HDL-C, obesity, hypertension, CHD family history.2) The single-vessel disease rates of CHD patients with the risk factors of male, smoking, hypercholesterolemia, diabetes, hypertension are35.2%,33.6%,30.8%,29.9%,35.0%, lower than the patients without the above risk factors (44.8%,41.1%, 39.7%,39.9%,43.7%), the difference is statistically significant (P<0.05); in the triple-vessel disease rates, patients with CHD in male, smoking, hypercholesterolemia, diabetes mellitus are38.0%,39.3%,42.2%,47.1%, higher than the patients without the above risk factors (27.9%,32.0%,33.4%,32.1%), the difference was statistically significant (P<0.05), but whether having hypertension has no significant effect on three-vessel disease rate; male, hypercholesterolemia, diabetes are significantly affecting the LM lesions rates,(9.0%:5.5%,11.7%:7.4%,12.2%:7.6%), the difference is statistically significant (P<0.05); the complete occlusion rate of male, smoking, high cholesterol, diabetic patients are15.1%,10.7%,17.0%,18.0%, higher than the female, non-smoking, the patients without hypercholesterolemia and diabetes (10.7%,11.9%,11.8%,12.8%); in the aspect of the Gensini total scores which reflects the severity of coronary artery lesions, male, smokers, diabetes, hypercholesterolemia are higher than women, non-smoker, no diabetes or hypercholesterolemia (44.32±33.39:36.49±31.78,46.02±33.96:39.15±30.06,50.85±41.07:39.89±33.70,52.15±41.05:39.60±34.83, P<0.05), while there is no difference between the hypertension and no hypertension CHD patients (42.80±36.74:40.92±33.21, P=0.414). With the age increasing, single-vessel disease rates show a downward trend, but the triple-vessel disease rates show a upward trend, and the Gensini total scores which reflects the severity of coronary artery lesions are significantly increasing (P <0.05).3) Comparison of men and women in different ages, the Gensini total scores at≥80-year-old age group, there is no significant statistical difference. While at<50-years-old (31.26±23.53:18.84±15.61),50-59-years-old (37.67±27.81:27.35±23.70),60-69-year-old (45.43±34.97:36.03±28.64),70-79years-old (52.91±41.41:42.16±34.21), the severity of coronary disease of male patients with CHD disease are higher than women, there is a significant statistically difference (P<0.05). And through the further comparison, we find that there is no significant statistical difference between men<50years,50-59years,60-69years,70-79years and women50-59years,60-69years,70-79years, and≥80years, suggesting that the same degree of coronary disease occurring among men is10years earlier than women; the Gensini total scores of smoking patients at<50years (34.10±26.12:20.83±17.37), 50-59-years (40.51±32.96:29.30±22.13),60-69-years (48.75±38.98:37.96±29.39),70-79-years (56.02±42.98:45.84±36.10) are higher than non-smoking patients with a significant difference (P<0.05), the two groups show no difference at>80years of age; to group by whether having hypercholesterolemia, comparing the Gensini total scores, there is no significant statistical difference between the two groups at the age>80years; while there is a significantly statistical difference at<50years old (39.41±33.75:26.60±20.26),50-59-year-old (43.06±34.58:33.73±28.24)60-69-year-old (52.27±42.82:39.27±30.36),70-79years old (58.76±46.42:46.71±population at36.69)(P<0.05); to group by whether having diabetes mellitus, comparing the Gensini total scores, there is no significant statistical difference between the two groups at the age>80years; while there is a significantly statistical difference at<50years (41.02±32.75:28.41±23.88),50-59years old (44.60±34.10:33.41±29.45),60-69-year-old (51.08±43.60:39.64±32.66),70-79years old (58.68±47.93:46.48±39.32)(P<0.05); to group by whether having hypertension, there is no statistical difference at the Gensini total scores of all the5ages.Conclusion:1) The major risk factors of coronary heart disease are male, age, smoking, obesity, high cholesterol, high LDL-C, low HDL-C, diabetes, high blood pressure.2) The most significant independent risk factor of Chinese coronary heart disease is diabetes, followed by smoking, high LDL-C, by age, gender, hypercholesterolemia, obesity, low HDL-C, obesity, hypertension, CHD family history.3) The rate of coronary three-vessel disease, LM lesions, complete occlusion in man is higher than that of women; the severity of coronary artery lesions in male is more serious than that of female at the four age groups of<50years old,50-59years,60-69years old,70-79years-old, male patients the degree of coronary lesions than women; and the same degree of coronary disease occurring among men is10years earlier than women;4) With the age increasing, single-vessel disease rates show a downward trend, but the triple-vessel disease rates show a upward trend, and the severity of coronary artery lesions are significantly increasing. 5) The rate of coronary three-vessel disease, complete occlusion and the incidence of acute myocardial infarction and pump failure in smoking patients are higher than that of no-smoking patients; the severity of coronary artery lesions in smoking patients is more serious than that of no-smoking patients at the four age groups of<50years old,50-59years,60-69years,70-79years.6) The rate of coronary three-vessel disease, LM lesions, complete occlusion in CHD patients with hypercholesterolemia or diabetes is hihger than those patients without the tow risk factors; the severity of coronary artery lesions is more serious at the four age groups of<50years old,50-59years old,60-69years old,70-79years-old in the CHD patients with hypercholesterolemia or diabetes; hypertension is a risk factor of coronary heart disease in Chinese people, while it is not a risk factor which could impact the severity of coronary artery lesions. |
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