| Objective(1) To investigate the relationship between the risk factors of coronary artery disease and the extent of coronary artery lesions.(2) To study the relationship between the aggregation of risk factors and the Gensini cumulative index of coronary artery lesions.MethodsTotal of 1129 consecutive patients with coronary heart disease (CHD) confirmed by coronary angiography in cardiology department of Tianjin Medical University affiliated the Second Hospital were studied retrospectively from October of 2008 to December of 2009 to investigate the relationship between the risk factors and the characteristics of coronary artery lesions.705 cases are male (averaged age was 62.42±11.22) and 424 cases are female (averaged age was 68.60±9.43).483 cases are complicated diabetes mellitus (42.78%) and 790 cases hypertension (69.97%). According to the results of coronary angiography, the degree of stenosis was expressed as percentage reduction of coronary diameter and cases were divided into four groups:mild lesion group (50%-74% stenosis in 101 cases), moderate lesion group (75-90% stenosis in 149 cases), severe lesion group (91-99% stenosis in 255 cases) and total occlusion group (100% stenosis in 624 cases). According to the scope of coronary artery disease, cases were divided into single vessel disease group (241 cases), double vessel disease group (301 cases) and three vessel disease group (587 cases). According to Gensini cumulative index, cases were divided into four groups, 218cases (19.31%) in group 1,297cases (26.31%) in group 2,240 cases (21.26%) in group 3 and 374 cases (33.13%) in group 4.328 cases (29.05%) were with acute myocardial infarction and 262 cases (23.21%) with old myocardial infarction,443 cases (39.24%) with unstable angina pectoris, and 96 cases (8.50%) with stable angina pectoris and other diagnosis. The characteriscis of sex, age and smoking in this study were analyzed as well.Results1.The age of patients is ranging from 28～81 years old (averaged age was 64.74±10.99). According to the scope of coronary artery disease, the average age of single vessel disease group(241 cases) is 57.13±10.35 years, double vessel disease group(301 cases) is 63.39±10.80 years and three vessel disease group(587 cases) is 64.45±11.20 years. The average age of each group has significant difference (P<0.001). All patients were divided into 4 groups by age stage:<45 years; 34 cases (3.01%),45～59 years:589 cases(52.17%),60～79 years:391 cases(34.63%);>80 years:115 cases(10.19%), The average age of each group has significant difference (P<0.001)2.705 cases are male (62.44%); 424 cases are female (37.56%).The degree of coronary artery lesions in male is significantly higher than that in female.Many datas including age, Gensini points, systolic blood pressure, pulse pressure, white blood cell count, fibrinogen, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, creatinine, uric acid, total bilirubin prominent are significantly different in statistics (p<0.05) whereas reduced triglycerides are not significant.3.701 cases of smokers account for 62.09% total number of patients; 428 cases of non-smokers account for 37.91%. With the increasing degree of coronary artery disease, the rate of smoking increase gradually, the difference is statistically significant (p<0.05). Groups devided by history of smoking (smoking less than 20 years group, smoking between 20 to 40 years group, smoking more than 40 years group) or amount of smoking (smoking less than 20 cigarettes/day group, smoking is greater than 20 Support/day group) shows significant statistical difference as well(p<0.001).4. According to the severity of coronary artery lesions and number of involved arteries, hypertension, we also found that hypertention, diabetes, hypertriglyceridemia, hypercholesterolemia, hyperuricemia, elevated serum creatinine, increased fibrino-gen, elevated white blood cell count, decreased total bilirubin increased were significantly associated with coronary artery disease (p<0.05).Among different groups,we found that low-density lipoprotein cholesterol, total cholesterol, triglycerides, fibrinogen, atherogenic index of plasma (AIP) in total stenosis were significantly higher than those in the mild disease group (p<0.001). Three vessel disease group was significantly higher than single vessel disease group (p<0.001). 5. With the increase in coronary risk factors, the degree of coronary artery disease gradually increased and the number of involved arteries increased as well, the difference was statistically significant (p<0.05).Conclusion1. Multiple risk factors for coronary heart disease is the result of the role. Age, smoking, diabetes, low-density lipoprotein cholesterol, fibrinogen are independent risk factors for coronary heart disease. High density lipoprotein cholesterol is an independent coronary heart disease protective factors.2. The level of hypertension, DM, smoking, age, male, TG, TC, LDL-C, Cr, UA, FIB, WBC is positively correlated with the degree of coronary artery lesions and Gensini cumulative index. Female and the level of HDL-C, TBIL are negatively correlated with the degree of coronary artery stenosis.3. The numbers of branch of coronary artery lesion involved in sex, age, hypertension, diabetes, smoking and other groups have significant difference.4. Degree of coronary artery disease not only correlated with the level of the risk factors but also correlated with cumulation of the numbers of risk factors.The more risk factors cumulate, the more serious coronary artery disease will be.The higher the degree of stenosis developes, the lesion count will be more and more, Gensini cumulative index will higher and higher. |
