The Clinical Risk Factors And Coronary Lesion Characteristics Of Premature Coronary Artery Disease

Background and Research Purpose: Background and Research Purpose: The age of the incidence group with coronary heart disease(CHD) is coming down and the premature coronary heart disease incidence tends to increase. The harm that premature coronary heart disease brings to patient’s prognosis and labor loss is much higher than that of late-onset coronary heart disease, thus the effective efforts made to prevent and reduce the incidence is of highly significience. A comparative analysis of the clinical features of CHD patients in different age groups was performed to discuss the clinical risk factors and the coronary artery lesion characteristics of CHD patients and thus hoping to provide information and basis for the prevention of premature coronary heart disease.Methods: With following up the databases and accessing the medical records of percutaneous coronary intervention from the First Affiliated Hospital of Dalian Medical University, this research successfully obtained 460 cases of patients who were hospitalized in ward 3 of CHD for the first time and underwent CAG check with complete information from January of 2013 to January of 2014.According to the fact of whether there were premature CHD(male is less than 55 years old and female is less than 65 years old), these patients were divided into 3 groups,one is with 150 cases of premature CHD, another is with 156 cases of non-premature CHD and a control group is with 154 cases of nonCAD. The patients’ basic clinical information were recorded in details. The results of CAG were analysised with SYNTAX score to assess the degree of coronary artery lesion.Results: 1, Compared with the non-CHD control group, the proportion of male patients, with smoking history(49.3%VS 10.4%,P<0.000) and the family history of CHD, in the premature CHD group is significantly increased; the total cholesterol(1.01±0.63 VS 1.10±0.26mmol/L, P<0.018), low density lipoprotein cholesterol( 1.01±0.63 VS 1.10±0.26mmol/L,P<0.018), apolipoprotein B1(0.65±0.25 VS 0.55±0.24 mmol/L,P=0.022) and high-sensitivity C-reactive protein(21.00±38.25 VS 4.26±6.46 mg/L,P<0.000)increased significiently;and high density lipoprotein cholesterol(1.02±0.63 VS 1.32±0.16mmol/L, P=0.033), apolipoprotein A1( 1.04±0.65 vs 1.25±0.26g/L,P=0.045) decreased significiently. The body mass index(BMI), hypertension history(30.0 %VS 42.2%,P=0.051) and diabetes history(9.3% VS 8.9%,P=0.059) of two groups have no obvious differences(30.0 %VS 42.2%;9.3% VS8.9%). 2, Compared with the non-premature CND group, the proportion with family history(23.3% VS 10.2%,P=0.008)and smoking history in the premature CHD group is obviously higher; the high-sensitivity C-reactive protein level(21.00±38.25 VS 8.28±15.48mg/L,P<0.005)is higher; the proportion of hypertension history(30% VS 75%,P=0.04)and diabetes history(9.3% VS 19.2%,P=0.045)is obviously lower. The gender proportion, BMI, blood lipids level, uric acid level and serum creatinine level show no significient differences between two groups. 3, Compared with non-premature CHD group, the ratio of myocardial infarction in the premature CHD group is higher(40.0% VS 13.0%,P=0.001); single branch lesion 90 coronary artery is easier to happen(60% VS 30.13%,P=0.000); the proportion of multi-vessel lesion 60(40% VS 38.4%,P=0.000), left main disease(2.01% VS 10.89%,P=0.000), left circumflex artery lesion(43.3% VS 57.69%,P=0.003) and right coronary lesion is significantly lower and left anterior descending artery lesion(86.67% VS 80.13%,P=0.392) between two groups show no obvious differences. Compared with non-premature CHD group, the SYNTAX score of premature CHD patients is lower(15.16±3.27 VS 23±13.36,P=0.000). 4, In the group of men less than 55 years old and women less than 65 years old, multi-factor Logistic analysis shows that high-sensitivity C-reactive protein(OR=1.734, 95%CI: 1.514~3.204), smoking history(OR=3.054, 95%CI: 1.801~5.487)and family history of CHD are independent risk factors of premature CHD.Conclusions: 1, Compared with non-CHD group, the proportion of the male patients, the patients with smoking history or family history or abnormal dyslipedemia in CHD group is higher and the high-sensitivity C-reactive protein level increased significantly. 2, The family history of CHD, the proportion of smoking history and the high-sensitivity C-reactive protein level in the premature CHD group are higher than those in the non-premature CHD group while the hypertension history and diabetes history are lower. 3, Multi-factor Logistic analysis on risk factors of premature CHD: high-sensitivity C-reactive protein, smoking history and family history of CHD are independent risk factors of premature CHD. 4, Premature CHD patients are more possible to be infected with heart attacks, which are mainly single branch coronary artery lesion, and the overall SYNTAX score is lower than that in non-premature CHD group.