Correlation Analysis Between Primary Dyslipidemia And Different Degrees Of Coronary Artery Disease In Patients With Coronary Heart Disease

Objective:To explore the primary dyslipidemia indexes related to coronary artery disease in patients with coronary heart disease.Methods:A total of 1623 the Zhuang nationality patients underwent coronary artery angiography for suspected coronary heart disease in affiliated hospital of You Jiang medical college for nationalities from January 1st,2015 to December 31 th,2017.1032 of them were diagnosed with coronary heart disease and the rest were patients without CHD.Patients with coronary heart disease were grouped according to three diffrent points that can reflect coronary lesions.(1)These patients were divided into coronary stenosis mild stenosis group,moderate stenosis group and severe stenosis group.(2)Those patients were divided into single vessel lesion group,double vessel lesion group and triple vessel lesion group.(3)Those patients were divided into stable angina pectoris(SAP)group,unstable angina pectoris(UAP)group and acute myocardial infarction(AMI)group.Next,the serum lipids level and other baseline data among the groups were analyzed by univariate analysis.Finally,confounding factors were controlled by binary logistic regression ordered Multi-classification Logistic regression analysis.Results:(1)The concentration of the triglyceride(TG)and apolipoprotein B(ApoB)were higher than that in the non-coronary heart disease group,while concentration of the high density lipoprotein cholesterol(HDL-C)and apolipoprotein A1(ApoA1)were lower than that in the non-coronary heart disease group.There were no difference in the concentration of total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and very low density lipoprotein cholesterol(VLDL-C).Gender,smoking,hypertension,age,HCY,β2-microglobulin,cystatin C,uric acid,C-reactive protein,fibrinogen,and troponin baseline data were statistically significant(P<0.05),while there was no significant difference in family history(P>0.05).(2)The increase of TG(OR=1.508,95%CI:1.502~2.164,P=0.026),and the increase of LDL-C(OR=2.001,95%CI:1.256~3.188,P=0.003)and the decline in ApoAI(OR=1.977,95% CI: 1.354~2.887,P=0.001)was independently and positively correlated with CHD after confounding factors were controlled.(3)With the increase of coronary stenosis,the concentration of HDL-C and ApoA1 overall emerge a reducing trend,while the concentration of ApoB showed a trend to gradually increase.After statistics processing,comparisons among three groups of HDL-C,ApoA1 were statistically significant.Other blood lipid indicators showed no difference among different groups.The pairwise comparison among these three groups indicated that ApoA1 were all statistically significant and that the levels of HDL-C in mild stenosis group were different from those in moderate and severe stenosis group.Gender,smoking,age,C-reactive protein,fibrinogen and troponin were confounding factors that had differences among these three groups.The differences mentioned above had statistical sense(P<0.05).(4)Logistic regression analysis showed that the decline in ApoA1(OR=1.921,95% CI: 1.349-2.736,P=0.001)were independently and positively correlated with the degree of coronary artery stenosis after confounding factors were controlled.(5)Overall,as the numberof coronary artery lesions increase,the concentration of HDL-C and ApoA1 overall emerged a reducing trend,while the concentration of LDL-C and ApoB showed a trend to gradually increase.After statistics processing,comparisons among three groups of HDL-C,ApoA1 and ApoB were statistically significant.The pairwise comparison among the three groups indicated that the concentration of HDL-C and Apo B were different between the single-stenosis group and the three-stenosis group.The Apo A1 levels were different among the three groups.Those differences mentioned above had statistical sense(P < 0.05).Smoking,age,cystatin C,C-reactive protein,troponin,fibrinogen were confounding factors that had differences among these three groups.The differences mentioned above had statistical sense(P<0.05).(6)Logistic regression analysis showed that the decline in ApoA1(OR=1.977,95% CI: 1.354~2.887,P=0.001)was independently and positively correlated with the numbers of coronary artery lesions after confounding factors were controlled.(7)With the increasingly aggravating degree of clinical types,the concentration of HDL-C and ApoA1 overall emerged a reducing trend.After statistics processing,comparisons among three groups of ApoA1 were statistically significant,while there were no difference in the concentration of TC,TG,HDL-C,LDL-C,VLDL-C and ApoB(P>0.05).The pairwise comparison among the three groups indicated that the difference of Apo A1 between SAP group and UAP group and that between SAP and AMI group were statistically significant(P<0.05).Gender,age,hypertension,smoking,C-reactive protein,fibrinogen,troponin were confounding factors that had differences among these three groups.The differences mentioned above had statistical sense(P<0.05).(8)Logistic regression analysis showed that the decline in ApoA1(OR=2.500,95%CI:1.725~3.623,P=0.001)and the decline in HDL-C(OR=1.516,95%CI:1.051~2.186,P=0.026)and the increase of ApoB(OR=2.491,95%CI:1.467~4.231,P=0.001)were independently and positively correlated with the severity of clinical types of coronary artery lesions after confounding factors were controlled.Conclusion:(1)Increased TG,elevated LDL-C and decreased ApoA1 were independent positive correlation factors for coronary heart disease.(2)The decrease of HDL-C,ApoA1 and ApoB in this study were independent positive correlation factors of coronary artery lesion aggravation.