Clinical Study On Hypertriglyceridemia And Severity Of Coronary Arteriosclerosis Lesion

ObjectivesWith increasing trend of morbility and mortality,coronary atherosclerotic heart disease(CHD)has become one of the cardiovascular diseases which harm human health and life quality.Etiology of CHD is very complicated with more 200 risk factors.Hypercholesterinemia has been well recognized as independent risk factor for CHD,but the relationship between hypertriglyceridemia and CHD has been debated for about 30 years.In recent 30 years,percutaneous coronary intervention(PCI)has been well developed,saving many lives of patients with CHD,and relieving their pain.Our study is to compare the clinical characteristics and PCI procedure characteristics in CHD patients with or without hypertriglyceridemia underwent PCI,to analysis the clinical characteristics,feafures of coronary artery lesion and interventional therapy,to evaluate the impact of hypertriglyceridemia on severity of coronary artery stenosis and clinical features.Methods1.We retrospectively analyzed 1367 records of patients who implanted metal stents during January 1 - December 31,2006 in Tianjin Chest Hospital.2.We recorded the fasting lipid results of second day after admission,including results of total cholesterol(TC),total triglyceride(TG),low density lipoprotein(LDL-C)and high density lipoprotein(HDL-C)and fasting glucose.We used the formula(non-HDL- C = TC—HDL- C)to calculate non-HDL-C.We divided the patients into two groups according to TG results: Hypertriglyceridemia(HTG)group(plasma TG＞1.70mmol/L);Non Hypertriglyceridemia(non-HTG)group(Plasma TG≤1.70 mmol/L).3.We collected clinical characteristics from patients' records;collected the parameters related to PCI from interventional therapy reports and compact disc of intervention,including extent of coronary artery lesion,severity of coronary artery stenosis,type of lension,parameters of implanted stents,etc.4.All statistical analyses were performed with SPSS,version 11.5.Two-sided values of P＜0.05 were considered statistically significant.Results1.There were 615 patients with hypertriglyceridemia and 752 patients without hypertriglyceridemia in 1367 patients with coronary artery disease underwent PCI. Patients in HTG group were younger than non-HTG group,and there were more diabetes in HTG group than non-HTG group(P＜0.05);Compared with non-HTG group,TC,LDL-C,non-HDL-C and fasting glucose were higher in HTG group than non-HTG group with statistical significance,but the difference in HDL-C between two groups was no statistical significance.2.Regarding the extent of coronary artery lesion(one,two,three vessels),there were no significant difference between the two groups(P=0.428);the artery distribution(left anterior descending coronary artery,left circumflex coronary artery, right coronary artery)in two groups were no significant difference(P=0.562,0.065, 0.685),triglyceride in patients with mild,moderate and severe stenosis were no significant difference(P=0.981).3.There were no significant differences between the two groups in number of interventional lesions,implanted stents,number of drug-eluting stents and metal bare stents,location,diameter,length,max dilation pressure,max dilation time of implanted stents(P＜0.05).Inclusion1.In CHD patients underwent PCI,those who have hypertriglyceridemia were much younger and had more diabetes.There were significant correlation between diabetes and hypertriglyceridemia.2.In CHD patients underwent PCI,there were no significant difference in extent of coronary artery lesion,severity of coronary artery stenosis,PCI parameters between HTG group and non-HTG group.3.Hypertriglyceridemia is a risk factor for CHD,it can promote CHD,but it didn't affect the extent of coronary artery lesion,severity of coronary artery stenosis, so it isn't the determiner on.severity of CHD.Hypertriglyceridemia may be related to intial formation of coronary arteriosclerosis and stablilization of plaque,but not related to severity of coronary artery stenosis.Unstable plaques are common in mild stenosis of arteriosclerosis(50%),mild coronary stenosis can lead to rupture of plaques and acute coronary events.Therefore,we must control hyperlipemia strictly in patients with new-onset CHD and mild coronary stenosis to prevent coronary events.