| Objective: The incidence of premature coronary artery disease increases in the world.This study aims to investigate the clinical characteristics of patients with premature coronary artery disease(PCAD)undergoing percutaneous coronary intervention(PCI),and to follow up the occurrence of major adverse cardiovascular and cerebrovascular events in PCAD patients within 2 years after PCI and to explore the influencing factors.Methods: This study retrospectively recruited patients with coronary heart disease who underwent PCI treatment at Lin Yi People’s Hospital from January 2017 to December 2018.The general clinical data,laboratory examination results and interventional treatment data of all patients were collected,and all patients were followed up the occurrence of major adverse cardiovascular and cerebrovascular events in PCAD patients within 2 years after PCI.All patients were divided into two groups according to age and gender,PCAD group and non-PCAD group.The baseline data,clinical features,and clinical events of two groups were compared.Kaplan-Meier survival was used to analyze and compare the differences in the incidence of clinical events between two groups.Univariate and multivariate Cox regression were used to analyze the influencing factor of clinical events in PCAD patients after PCI at 2 years.Results: A total of 217 patients with coronary heart disease were included in this study,including 91 PCAD patients(41.9%)and 126 non-PCAD patients(58.1%).Compared with non-PCAD,the proportion of male of PCAD group was higher(89.0% vs77.8%,P=0.032);the difference of age was statistically significant(P<0.05);the proportion of cerebral infarction in the non-PCAD group was significantly higher than that of PCAD Group(22.2% vs 4.4%,P<0.001);the use rate of clopidogrel in the PCAD group and non-PCAD group(11.0% vs 27.8%,P=0.003)and the use rate of ticagrelor(83.5% vs 69.8%,P=0.021),the use rate of β-blockers(89.0% vs 78.6%,P=0.044),and the use rate of diuretics(17.6% vs 36.5%,P=0.002)were statistically different;Laboratory examination results showed differences in the levels of systolic blood pressure,diastolic blood pressure,white blood cell count,red blood cell count,hemoglobin,alkaline phosphatase,triglycerides,high-density lipoprotein,and brain natriuretic peptide were statistically different between two groups(all P<0.05).There was no significant difference in the coronary artery condition and the number of implanted stents between the two groups(P>0.05).A total of 19 patients in the PCAD group occurred adverse cardiovascular and cerebrovascular events,accounting for 20.9%;a total of 45 patients in the non-PCAD group had adverse cardiovascular and cerebrovascular events,accounting for 35.7%.The difference of the incidence of MACCE between the two groups was statistically significant(P=0.018);the incidence of revascularization in the PCAD group was lower than that of non-PCAD group(2.2% vs 11.1%,P=0.013).The stent thrombosis rate in the PCAD group was 8.8%,and the stent thrombosis rate in the non-PCAD group was 9.5%,the difference was not statistically significant(P>0.05).Kaplan-Meier survival analysis showed that the incidence of MACCE in the PCAD group was lower than that in non-PCAD group,and the difference was statistically significant(P=0.006).Multivariate Cox regression analysis showed that PCAD,age,history of cerebral infarction,and triglycerides were the influencing factors of MACCE in CAD patients.While PCAD was a protective factor(HR=0.431;95%CI: 0.256-0.745;P=0.025);age(HR=1.104;95%CI: 1.045-1.946;P=0.012),history of cerebral infarction(HR=1.827;95%CI: 1.275-2.658;P=0.024),triglycerides(HR=1.147;95%CI: 1.054-1.843;P=0.005)are risk factors.Conclusion: There are certain differences in the basic data and clinical characteristics of PCAD patients and non-PCAD patients,including age,gender,and history of cerebral infarction;the incidence of major adverse cardiovascular and cerebrovascular events during the 2-year follow-up period in PCAD patients is lower than that of non-PCAD patients.PCAD,age,history of cerebral infarction,and triglycerides are the influencing factors of major adverse cardiovascular and cerebrovascular events in patients with coronary heart disease,and age,history of cerebral infarction,triglycerides are risk factors. |
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