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

Objective:further understand the risk factors and the coronary artery lesions of the young CHD patients, so as to provide clues for treating and preventing the CHD among the young populations.Method:241patients aged less than45years old enrolled in Department of Cardiology, Xiangya Hospital from April2011to December2012who received coronary angiography were collected according to the inclusion and exclusion criteria. They were classified classified young group (241cases) and elderly group (214cases).according to angiography,young group were classified classified CHD (148cases) and non-CHD group(93cases). The conditions of risk factors such as general items, smoking, hypertension, history of diabetes, blood tests (lipids, uric acid, total bilirubin, cystatin, GGT, etc) of all cases were recorded, and they were grouped according to Gensini score based on the results of coronary angiography and lesions. Using SPSS18.0statistical software to analyze data.Results:(1) The ratios of hypertension, diabetes, smoking and male of in the young CHD group were higher than those of the non-CHD group. UA, TC, TG, Cys-C, LDL, GGTin the young CHD group were higher than those in the non-CHD group (P<0.05), while the HDL in the young CHD group was lower than that of the non-CHD group (P<0.05).(2) logestic regression analysis showed that the diabetes was the most significant independent risk factor of CHD in young patients (OR=2.614), followed by other factors:smoking (OR=2.268), cholesterol (OR=1.335) and GGT (OR=1.008).(3) In the young CHD group, with the rise of the Gensini score of coronary artery lesions and increasing number of coronary artery lesions, the ratios of male, hypertension, diabetes, smoking were significantly increased, and the TC, TG, LDL, GGT level were significantly elevated, showing a positive correlation (P<0.05), while the HDL level was dropped, showing a negative correlation (r=-0.316, P<0.05). (4) The ratios of male and smoking in the young CHD group were higher than those of the elderly group (P<0.05).The TC, TG, LDL, GGT level of the young CHD group were higher than those of the elderly group (P<0.05)and the Cys-C level lower than elderly group.(5) The ratio of single vessel disease in young CHD group was higher than that of the elderly CHD group (P<0.05) and the left anterior descending artery lesion dominated, followed by the circumflex artery. The ratio of triple vessel disease in young CHD group was lower than that of the elderly CHD group (P<0.05). The ratios of the LAD, LCX, RCX in young CHD group were lower than the elderly CHD group.(6)The ratio of Gensini scores in group1and group2in young CHD patients was higher than that of the elderly CHD group (P<0.05), while the ratio of the group5in young CHD patients was lower than that of the elderly CHD group (P<0.05).Conclusion：(1)The risk factors of young CHD are diabetes,smoking,TC; and diabetes is the most significant independent risk factor of CHD in young populations。(2)The ratio of male, hypertension, diabetes and smoking, and serum TC, TG, LDL, GGT level are positively correlated with the coronary stenosis severity of young CHD patients.(3)The ratios of male, smoking and the TC, TG, LDL, GGT level in the young CHD group are higher than those in the elderly CHD group. The Cys-C level lower than elderly group.(4)The coronary artery lesions in the young CHD group is lighter than the elderly CHD group and the left anterior descending branch dominates.