Risk Factors And Characteristic Of Coronary Artery Lesions In Young Patients With Coronary Heart Disease

Objective: Coronary heart disease (CHD) has been the leading killer ofhuman health. The incidence of CHD increases yearly and its onset age isgetting younger. Therefore, the young adults (≤45years) with CHD havebecome an important issue we have to pay more attention. Compared witholder patients, firstly,one or more of the CHD risk factors is present in themajority of young adults with CHD, but the roles between young and elderlypatients with CHD are different. Although there is lot of related research,theresearch results are different. Secondly, the coronary artery lesions are alsodifferent from young to old patient group. In this study, we retrospectivelyanalyze the characteristics of coronary artery lesions and CHD risk factors ofyoung adults with CHD, and explore the pathogenesis of CHD in youngpeople.Methods: A total of71cases of young adults with CHD by coronaryartery angiography from April2006to October2011were studiedretrospectively, and selected418cases of old patients with CHD over the sameperiod as controls. Collect the general information, CHD risk factors, such assmoking, family history of CHD, hypertension, type2diabetes mellitus, andthe results of coronary artery angiography. Group the patients according to thecharacteristics of coronary arteries lesions and Gensini cumulative score.Analyze the CHD risk factors and characteristics of coronary artery lesions inyoung group with CHD,and compare them with the old patient group.Results:①F amily history of CHD, type2diabetes mellitus, TC andLDL arepositively correlated with the number of stenosed coronary artery branches (P＜0.05or P＜0.01).②Smoking, family history of CHD, hypertension, type2diabetes mellitus, TC and LDL are positively correlated with Gensinicumulative score of in the young adults with CHD(P＜0.05or P＜0.01). ③The proportion of male, family history of CHD, smoking and the level ofTG in the young adults patients is higher than in the old(P＜0.01), while theproportion of hypertension and the level of LDL is lower in the young(P＜0.05).④The lesions of coronary artery in the young patients are mostly singlelesions. The proportion of lesions in left anterior descending artery (LAD) isthe highest. Compared with the old patient group, the proportion of patientswith two or more than two stenosed coronary artery branches of the youngpatient group are lower(P＜0.05), and the proportions of lesions in LAD, LCXor RCA are lower than in the old patient group.⑤The Gensini cumulativescore of coronary artery of the young group is lower than that of old patientgroup(52.34±35.85VS67.34±45.42). The proportions of the5thGensinicumulative score group(＞64) in the young patients is higher than in the old(P＜0.01).⑥Acute myocardial infarction(AMI) accounted for the largest theproportion(49.3%) of young CHD,followed by29.6%of stable anginapectoris (SAP) and21.1%of unstable angina pectoris (UAP). It is mainlyUAP in the old patients with CHD.Conclusion:①There was a positive correlation between the severity ofcoronary artery lesions of young CHD patients and family history of CHD,type2diabetes mellitus, smoking, hypertension and the level of TC and LDL.The proportions of male, smokers, family history of CHD and the level of TGof young patients are higher than the old, while the proportions ofhypertension and the level of LDL is lower.②MI, especially AMI, is the mostcommon in the young adults with CHD, and the proportions of them arehigher than those in the old while the proportion of UAP is lower in theyoung.③The lesions of coronary artery in the young patients are mostly singlelesions, and most of them occur in the LAD. On the whole, the coronary arterylesions of young patients with CHD are lighter than those in the elderly.