The Analysis Of The Clinical Characteristics And The Relationship Between Coronary Artery Stenosis And The Risk Factors Among Different Ages Of Coronary Heart Disease Patients

Objectives To explore the clinical characteristics and the relationship between the degree of coronary artery stenosis and the risk factors in different ages of coronary heart disease patients.Methods From February 2016 to February 2017,622 patients with coronary artery stenosis ≥50% were continuously collected who admitted to the Department of Cardiology of Tangshan Gongren Hospital.The patients were divided into young and middle group(n=347)and elderly group(n=275)according to age ≥60 years.The comparisons were made between 2 groups in the following aspects: age,sex,smoking,hypertension,diabetes,hyperlipidemia,body mass index(BMI),angiographic data and the levels of glucose,total cholesterol(TC),triglycerides(TGs),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and lipoproteinassociated phospholipase A2(Lp-PLA2).Statistical analysis was performed using SPSS 19.0 software.Results were presented as mean±standard deviation for continuous variables,and percentages for categorical data.Groups were compared(all test 2 sided)by paired t-test.Frequencies or Fisher exact probability method were compared using 2 test.A multivariate logistic regression model was used to test the association of baseline variables with Gensini scores.Significant differences were assessed in the groups(P < 0.05).Results 1 Compared with elderly group,the prevalance of males was significantly higher in the young and middle-aged(274 vs 162,P <0.05,respectively),as well as the incidence of smoking,drinking,BMI and family history(P <0.05).However,the incidence of diabetes,hypertension and the level of HDL-C,plasma Lp-PLA2,Gensini scores was lower in the young and middle-aged group than that in the elderly group(P <0.05).2 The incidence of unstable angina and acute myocardial infarction in young and middle-aged groups were significantly higher in the young and middle-agedthan that in the elderly group(165 vs 102,P <0.001;111 vs 60,P <0.05,respectively),but the incidence of stable angina was lower than that in the elderly group(71 vs 113,P <0.001,respectively).3 Coronary angiograghy results demonstrated that(1)in the young and middle-aged group,the incidence rate of coronary artery disease with 1-vessel diseases was significantly higher than that in the elderly group(175 vs 60,P <0.001,respectively),while the incidence of the 3-vessel disease was significantly lower than that in the elderly group(60 vs 112,P <0.001,respectively).However,the incidence of 2-vessel diseases was similar between the two groups(112 vs 93,P >0.05,respectively).(2)In elderly group,the proportion of patients with an stenosis-associated left circumflex coronary artery(LCX)was significantly lower than in the young and middle-aged group(90 vs 41,P <0.001,respectively),while the proportion of stenosis-associated right coronary artery(RCA)was higher than that in the young and middle-aged group(60 vs 91,P <0.001,respectively).There were no statistical significance in the incidence of stenosisassociated left anterior descending vessel(LAD)and on the left main artery(LM)(165 vs 123;32 vs 20,P >0.05,respectively).4 Correlation analysis of coronary artery lesions and risk factors in the two groups: the independent risk factors of Gensini Score in young and middle-aged group were diabetes,smoking,hypertension,hyperlipemia,family history,and TC(OR was 14.329,5.980,5.298,4.712,3.347,2.242,respectively),while HDL-C was a protective factor(OR value was 0.031)for Gensini Score;the independent risk factors of Gensini Score in elderly patients are diabetes,TC and Lp-PLA2(OR was 3.115,1.832,1.014,respectively).Conclusions 1 The young and middle-aged patients with coronary artery disease frequently accompany with smoking,drinking,overweight,family history of coronary artery disease,and low level of HDL-C,while elder patients accompany with hypertension,diabetes,and high Lp-PLA2.Male was an important risk factor for coronary artery disease in every group,especially in young and middle-aged group.2 In young and middle-aged patients,unstable angina pectoris(UA)and acute myocardial infarction(AMI)were more common,and the 1-vessel diseases was in the majority.The stable angina pectoris(SA)was more common in elderly patients,and 3-vessel diseases is in the majority.The major reason of coronary artery disease in every group was left anterior descending artery(LAD).3 Gensini Score in young and middle-aged patients was related to hypertension,smoking,family history and low level of HDL-C.Gensini Score in elder patients were associated with Lp-PLA2.Diabetes and TC could increased degree of coronary artery stenosis in two groups.