The Risk Factors Of Calcified Aortic Valve Stenosis In The Elderly

Objective Previous studies have shown that coronary heart disease is a risk factor for calcific aortic stenosis.So,this study was designed to remove the effect of coronary heart disease on calcific aortic stenosis in the elderly population.By analyzing the association between calcified aortic stenosis(except coronary heart disease)and clinical factors in the elderly population(?65 years old).To clarify the risk factors for the incidence of calcified aortic valve stenosis in the elderly.In addition,the differences between clinical factors of calcific aortic valve stenosis in elderly patients with coronary heart disease and senior patients with coronary heart disease were further compared.The aim is to clarify the risk factors associated with the onset of calcific aortic valve stenosis in elderly patients with coronary heart disease,and to provide a strong basis for the prevention and treatment of the disease.Methods A total of 258 patients who had been hospitalized because of chest discomfort were collected retrospectively from June 2015 to June 2017.Aortic stenosis was diagnosed by echocardiography and coronary angiography was used to diagnose coronary heart disease.All patients were divided into four groups(ie,calcific aortic valve stenosis group,coronary heart disease with calcific aortic valve stenosis group,coronary heart disease group,and control group).Basic demographic information of patients,relevant clinical data,echocardiography-related indicators of admission,laboratory test indicators and other common blood indicators were collected,including gender,age,history of smoking,history of hypertension,history of diabetes,white blood cell count(WBC),Neutrophil ratio(N%),neutrophil lymphocyte ratio(NLR).Hypersensitive C-reactive protein(hsCRP),amino-terminal B-type natriuretic peptide(NT-pro BNP),total cholesterol(TC),triglyceride(TG),apolipoprotein alpha(apo-alpha),high density lipoprotein(HDL),low density lipoprotein(LDL),very low density lipoprotein(VLDL),and so on.1.Above indicators were compared in the calcific aortic valve stenosis group and the control group.Then the above indicators were graded,and multivariate logistic regression equation was used to analyze the related risk factors of elderly patients with calcific aortic valve stenosis.2.Above indicators were compared in the coronary heart disease group and coronary heart disease comnbined with calcific aortic valve stenosis group.Then the above indicators were graded,and multivariate logistic regression equation was used to analyze the related risk factors of elderly patients with oronary heart disease comnbined with calcific aortic valve stenosis.Results:A total of 258 subjects were included,including 78 in the control group,aged 68.92±5.29 years old;36 in the calcified aortic valve stenosis group,aged71.11±7.62 years old;40 patients in the coronary heart disease complicated with the calcified aortic valve stenosis group,aged 70.43±6.94 years old;104 in the coronary heart disease group,aged 66.10±4.82 years old.The age of the coronary heart disease comnbined with calcific aortic valve stenosis group was higher than the coronary heart disease group,the difference was statistically significant(p<0.05).In terms of gender,no difference between groups.In terms of smoking history,the number of smokers in the calcified aortic valve stenosis group(63.90%vs26.90%),in the coronary heart disease group(48.10%vs 26.90%),and in the coronary heart disease group with the calcified aortic valve stenosis group(69.00%vs26.90%)were higher them that in control group,and the difference was statistically significant(p<0.05).With diabetes,the number of patients in the calcified aortic valve stenosis group(50.00%vs 19.20%)and coronary heart disease group(42.30%vs 19.20%)was higher than that in the control group,and the difference was statistically significant(p<0.05).With hypertension,the number of patients in calcified aortic valve stenosis group(88.90%vs 67.90%)was higher than that of the control group,and the difference was statistically significant(p<0.05).Blood results showed that the ratio of neutrophils(68.80%vs 61.35%),neutrophils(4.65×10~9/L vs 3.65×10~9/L)),granuloma ratio(3.18 vs 2.07),and high-sensitivity C-reactive protein(3.15 mg/L vs 1.00 mg/L),the amino-terminal B-type natriuretic peptide(1849.50 pg/ml vs 105.00 pg/ml)in the calcified aortic valve stenosis group was higher than the control group.The difference was statistically significant(p<0.05).Blood lipid results showed that total cholesterol(5.17 mmol/L vs 4.68 mmol/L)and very low-density lipoprotein(0.42 mmol/L vs 0.31 mmol/L)in the main stenosis group were higher than those in the control group,and the difference was statistically significant(P<0.05);High-density lipoprotein(1.21 mmol/L vs 1.34 mmol/L)was lower than the control group,and the difference was statistically significant(P<0.05).The multivariate Logistic regression equation for calcific aortic stenosis showed that smoking history(OR=18.306,P=0.002),neutrophil count(OR=27.115,P=0.045),lymphocyte count(OR=0.0056)P=0.025),apolipoprotein alpha(OR=14.270,P=0.018),total cholesterol(OR=7.946,P=0.025),high-sensitivity C-reactive protein(OR=6.455,P=0.047),amino-terminal B-type natriuretic peptide(OR=219.349,P=0.000)was significant.The multivariate logistic regression equation of coronary heart disease showed diabetes(OR=3.148,P=0.044),gender(OR=5.131,P=0.002),age(OR=0.450,P=0.019),high-density lipoprotein(OR=0.221).(P=0.001),and amino-terminal B-type natriuretic peptide(OR=9.134,P=0.000)was significant.The multivariate logistic regression equation for coronary heart disease combined with calcific aortic valve stenosis showed that age(OR=2.656,P=0.001),particle ratio(OR=1.430,P=0.009),high-density lipoprotein(OR=2.797,P=0.007)Very low density lipoprotein(OR=3.640,P=0.020)is significant.Conclusions:1.The history of smoking,neutrophil count,apolipoprotein alpha,total cholesterol,high-sensitivity C-reactive protein,and amino-terminal B-type natriuretic peptide were the independent risk factors for the development of calcified aortic valve stenosis in the elderly;2.Age,neutrophil to lymphocyte ratio and very low density lipoprotein are the risk factors for the occurrence of coronary heart disease combined with calcific aortic valve stenosis.In summary,it can be found that calcified aortic valve stenosis in the elderly is not a degenerative disease,and it is closely related to systemic inflammatory respond and abnormal lipid metabolism.For elderly patients with coronary heart disease,we must strengthen lipid-lowering therapy and anti-inflammatory treatment to prevent the occurrence of calcific aortic stenosis.