Analysis Of Clinical Characteristics And Risk Factors In Premanopausal Women With Coronary Heart Disease

Background:The recent studies showed specific physiology protection mechanism of premanopausal women. The endogenous estrogen of physiology level in their bodies was helpful to regulate lipid metabolism , provent and delay artherosclerosis , protect blood vessel endothelium , inhibit vascular smooth muscle hyperplasing , dilat blood vessel , degrade angiotasis , improve blood rheology , improve insulin resistance , raise survival rate and quality of life of premanopausal women patients with coronary heart disease ( CHD) . The prevalence of CHD of premanopausal women was extremely low . Recently , the prevalence of CHD raised up gradually , and age of onset descended gradually . The CHD of young women had common characteristic of CHD , and had specificity . The studies to premanopausal women with CHD are still few now . This article compares and analyzes clinical characteristic,correlated risk factors and coronary arteriongraphy (CAG) outcome of premanopausal women patients with CHD by means of case control study design , and provid some evidence for diagnosis and therapy, and avoiding missed diagnosis and misdiagnosis .Objective: To study the clinical characteristics and risk factors in premanopausal women with coronary heart disease (CHD).Methods: Eighty-six premanopausal female patients with chest pain from Dalian Medical University First Affiliated Hospital and Dalian Jinzhou first People Hospital between 2003.01～2007.01 were classified in CHD group and contrast group by coronary angiography (CAG) . Risk factors, clinical symptoms and CAG characteristics were analyzed retrospectively .Results:Eighty-six patients, forty cases in coronary group withaverage age 42.6±5.8 years, forty-six cases in contrast group with average age 43.8±4.6 years . Compared risk factors between two groups : combined hypertension respectively 67.5% vs 13.0% , diabetes 50.0% vs 8.7% , hyperlipidernia 55.0% vs 13.0% , there were statistics differences between two groups (P< 0.05). Total cholesterol (TC),trilyceride (TG),high density lipidprotein cholesterol (HDL-C) and lipoprotein a (Lp(a)) , there were statistics differences between two groups (p< 0.05) . Other risk factors of women CHD such as CHD family history , smoking , oral contraceptives , whether hormone replacement therapy (HRT) , there were no statistics differences (P>0.05) . TC,low density lipidprotein cholesterol (LDL-C),Lp(a) , there were statistics differences between two subgroups of single vessel lesion and multi-vessel lesion (p<0.05). Compared clinical symptoms : there were more typical angina pectoris in coronary group (30/40 cases ,75% vs 4/46 cases , 8.7%) . The specificity change of ECG , 34/40 cases in coronary group , 15/46 cases in contrast group . The change of ST-T was more observed in coronary group (26/34 cases ,76.5% vs 3/15 cases , 20%) . The change of alone T-wave was more observed in contrast group (8/34 cases , 23.5% vs 12/15 cases , 80%) . Single vessel coronary disease was observed more frequently , about 80% , most of all were localized lesions , and left anterior disending artery was the most frequently involved vessel . Left ventricular ejection fraction (LVEF) and left ventricular end-diastole internal diameter (LVEDD) , there were no statistics differences between two groups (p>0.05) .Conclusion: Hypertension,diabetes and/or hyperlipidemia are major risk factors in premanopausal women with CHD . The extent of coronary artery lesion is closely related to hyperlipoidemia . Premanopausal women with typical angina pectoris and ST-T changes should be suspected CHD . Single vessel coronary disease was observed more frequently , most of all were localized lesions , and left anterior disending artery was the most frequently involved vessel . The change of alone T-wave don' t reflect stenosis of coronary artery . The heart function is mainly fine procedure .