Analysing The Risk Factors And Prognosis Of Coronary Microvascular Angina Pectoris

【Objective】Retrospectively analysed the risk factors and prognosis of coronary microvascular angina pectoris.【Method】1.268 cases of patients were enrolled from the First Affiliated Hospital of Hainan Medical college Cardiovascular Department,who seen a doctor from August 2012 to June 2019 for the first time of chest pain and coronary angiography prompted coronary artery stenosis< 20%,patients’ general datas(admission number,gender,age,baseline information,telephone number,and time of first hospitalization due to chest pain)were collected;According to the diagnostic criterias of coronary microvascular angina,patients were divided into observation group and control group,110 cases of patients with coronary microvascular angina(46 males,mean age 56.72±8.49 years)were included in the observation group,and 112 cases of patients with non-cardiac chest pain(50 males,mean age 56.43±10.49 years)were included in the control group.2.Patients were followed up by telephone;Recruited screening were complet-ed from August to December 2019;All follow-up were finished by the time between August to December 2020.From the first hospitalization time of chest pain to the end of follow-up,the shortest and longest time of the observation group were 1.5 years and 8.3 years,and the mean time was 4.22±1.20 years.The shortest and longest time of the control group were 3.5 years and 7.6years,and the average time was 4.33±0.66 years.Statistical ana-lysis showed that there was no significant difference in the length of time from discharge to follow-up between the two groups(P > 0.05).Recorded all patients’ primary ending events、secondary ending events、other advers eevents,investigated and recorded the SAS scores and the scores of SF-36.3.Collected all subjects’ platelet index fasting lipid,myocardial enzymes,left ventricular function and structure,and interventricular septal thickness.4.Analysed the platelet index,fasting blood lipid,myocardial enzyme,left ventricular function and structure index,ventricular septal thickness between groups and used Logistic regression analysis to analysed the risk factor;Analysed the primary and secondary end events,adverse events,prevalence of SAS anxiety,quality of life of SF-36 survey between groups。【Results】Compared with the control group,the proportion of large platelets [27.7%(22.53%-32.58%)vs 24.2%(20.6%-29.83%)],the width of platelet volume distribution [11.45%(10.40%-12.80%)vs 11.11%(10.20%-12.35%)],lipoprotein A[144.18(82.82～280.29)mg/L vs 103.32(73.81～167.46)mg/L] was dramatic increased(P<0.05)in the observation group,Apo A[1.25(1.18-1.37)g/L vs1.32(1.22-1.42)g/L)] was dramatic declined(P<0.05)in the observation group.There were no statistical differences in other laboratory marker(P>0.05)between the two group.The ventricular septal thickness [9.00(8.00～10.00)mm vs 8.00(8.00～9.00)mm] in the observation group was significant higher than that in the control group(P<0.05).There were no statistical differences in the left ventricular function and construction index between the two groups(P>0.05).Logistic regression analysis showed within the medical reference interval,ventricular septal thickness increased is an independent risk factor for coronary microvascular angina.Compeared with the control group,the primary and secondary ending events rate in the observation group hadn,t statistical increase(P>0.05),The recurrence rate of chest pain of the observation group had a significant increases(P<0.05);The rate of Kidney-related events between the two groups hadn,t statistical difference(P>0.05).Compared with the control group,the prevalence of anxiety in the observation group was significantly increased [25(22.7%)vs 10(8.9%)](P < 0.05),the Physiological function score [85.00(85.00～95.00)vs 90.00(85.00～95.00)],Role-Physical score [75.00(75.00～100)vs 100(75.00～100)],energy score [80.00(75.00～90.00)vs90.00(85.00～95.00)],social function score [88.89(72.78～88.89)vs 100(88.89～100)] in the observation group was significantly decreased than that in the control group(P < 0.05).【Conclusion】1.Coronary microvascular angina was associated with the increased of proportion of large platelet,and width of platelet volume distribution,higher lipoprotein A and lower apolipoprotein A;2.Within the medical reference interval,ventricular septal thickness increased is an independent risk factor for coronary microvascular angina;3.Coronary microvascular angina could lead to the chest pain recurred,the disease was related with anxiety and could reduce patients’ long-term quality of life。...