| Objective To study the number of coronary artery lesions and the severity of coronary stenosis of elderly woman with acute myocardial infarction, and the influence of the risk factors on characteristics of coronary artery lesions.6Methods 1.Retrospectively collected from Ji Ning NO1 hospital from January, 2009 to January, 2014, there are 350 cases of female patients above 60 were diagnosed as acute myocardial infarct and they had received coronary angiography examination. Inspect and record the previous smoking history, hypertension history, diabetes history, dyslipidemia condition, the data of the coronary angiography in detail. For age, using the latest standard of age seted by the World Health Organization(WHO) to divide the 350 cases into two age parts: the first age part is for 242 cases of ‘young elderly man’ with 60-74 years old and the second age part is for 108 cases of “old people” who is greater than or equal to 75 years old. Coronary artery lesions feature is described as folllows:(1) The coronary artery lesions vessel numbers is divided into 3 parts: single vessel lesion, double-vessel lesions and multiple- vessel lesions;(2) Gensini integral is graded according to quartile method, namely: 21-39 points for grade a of coronary artery stenosis; 40-50 points for grade b; 51-82 pointsfor grade c and 83-98 points for grade d of coronary stenosis. 2. Use SPSS17.0 statistical software to analyze the relationship of each risk factor with coronary artery lesions vessel numbers and degrees, and make factor Logistic regression model analysis at the same time.Results1.The relationship between age and characteristic of coronary artery lesions: Based on the analysis of Spearman correlation, the age is positively correlated with the number of coronary artery lesions, and the coefficient of correlation is 0.430, P=0.000. The age is positively correlated with the severity of coronary stenosis, and the coefficient of correlation is 0.415, P=0.000. It seems that the older female AMI patients have more coronary artery lesions and more severe severity of coronary stenosis. 1.1 The comparison of constituent ratio of the number of coronary artery lesions and the severity of coronary stenosis between two age groups: Distribution constituent ratio of lesion vessel numbers and coronary artery stenosis degree of AMI patient in this two age groups is significantly different(P is all equal to 0.000); the proportion of grade c and grade d of coronary artery stenosis degree and multiple-vessel lesions of patients above 75 years old is higher, namely are 36.1%, 38.0% and 37.0%,and its differences are significant compared with 60-74 years old group(P is all less than 0.05); the proportion of single vessel disease, stenosis grade a and grade b in 60-74 years old group is higher, namely are 44.6%, 31.0%, 31.4%, and its statistics differences are obvious compared with 60-74 years old group(P is all less than 0.05). 1.2 The comparison of ages between two groups with different constituent ratio of the number of coronary artery lesions and the severity of coronary stenosis:In this two age groups, notable differences(P is all less than 0.001))exist on different coronary artery lesions vessel numbers and different severity of coronary artery stenosis of different age level; age level for multi-vessel disease group is higher, for 75.23±7.23 years old; age level for single vessel disease group is lower, for 67.31±6.13 years old, and there are notable differences(P<0.05); level age for stenosis grade d is the highest, for 75.05±7.79 years old, it is higher than age level of stenosis grade a, b and c and there are notable differences(P is all less than 0.05).2. The relationship between risk factors and characteristic of coronary artery lesions 2.1 The relationship between dyslipidemia and coronary artery lesions: Based on the analysis of Spearman correlation, the dyslipidemia is positively correlated with the number of coronary artery lesions and the severity of coronary stenosis, and the coefficient of correlation of the former is 0.199, P=0.003 with the later one being 0.367, P=0.000. However, the dyslipidemia has stronger correlation with the severity of coronary stenosis. It seems that the older female AMI patients have higher gensini points and more severe severity of coronary stenosis. 2.2 The relationship between diabetes and coronary artery lesions: The analysis of Spearman correlation shows that the diabetes is clearly associated with the number of coronary artery lesions and the severity of coronary stenosis, either. The coefficient of correlation of the former is 0.557, P=0.000 with the later one being 0.479, P=0.000. However, the diabetes has stronger correlation with the coronary artery lesions. It seems that the older female AMI patients with diabetes have more coronary artery lesions. 2.3 The relationship between hypertension and coronary artery lesions: Based on the analysis of Spearman correlation, hypertension is positively correlated with lesion vessel numbers and coronary artery stenosis degree, and the coefficient of correlation of the former is 0.208, P=0.003 with the later one being 0.428, P=0.000. However, hypertension has stronger correlation with the severity of coronary stenosis;The grading of hypertension is also associated with both the number of coronary artery lesions and the severity of coronary stenosis, and the former coefficient of correlation is 0.240, P=0.003,the later one is 0.477, P=0.000, However, the grading of hypertension has stronger association with the severity of coronary stenosis, either. It seems that the old female AMI patients with hypertension and higher hypertension grading have higher gensini points and more the number of coronary artery lesions. 2.4 The relationship between smoking and coronary artery lesions: The analysis of Spearman correlation shaows that the smoking is obviousiy associated with the number of coronary artery lesions and the severity of coronary stenosis, and the former coefficient of correlation is 0.160, P=0.003,the later one is 0.210, P=0.000, It seems that the old female AMI patients with the habit of smoking have more coronary artery lesions and more severeseverity of coronary stenosis. However, the correlations are relatively weaker. 3.Multi-factor Logistic Regression Analysis 3.1 Multi-factor logistic regression analysis of coronary artery lesions vessel numbers: Take the coronary artery lesions vessel numbers as dependent variables, and use single factor to analyze the meaningful variables(hypertension, diabetes, dyslipidemia, smoking, age)as independent variables for regression analysis. The fitting results found hypertension, diabetes, and age are the independent influence factors of coronary artery lesions vessel numbers(P<0.05), the risk of high coronary artery lesions vessel numbers in patient without diabetes, hypertension is lower. The risk of high coronary artery lesions vessel numbers among people who is equal or greater than 75 years old is higher. 3.2 Multi-factor logistic regression analysis of coronary artery stenosis degree:Take the coronary artery stenosis degree as dependent variables, and use single factor to analyze the meaningful variables as independent variables for regression analysis. The fitting results found hypertension, diabetes, dyslipidemia and age are the independent influence factor of severity of coronary stenosis(P<0.05), non-hypertension,non-dyslipidemia and non-diabetes are the protective factors of coronary artery stenosis degree and the risk of more severe severity of coronary stenosis is lower. Age that is equal or greater than 75 years old is the risk factor, and the risk of high coronary artery stenosis degree is higher among this group.Conclusion1. The coronary artery lesions vessel numbers and severity of coronary stenosis of elderly female AMI patients has a positive correlation with age, hypertension, hypertension grade, hyperlipidemia,smoking and diabetes. 2. Coronary artery lesions for female AMI patients between 60 to 74 years old are more for single vessel disease and double-vessel disease; the gensini integral of coronary artery stenosis degree is among 28 to 50 points; Coronary artery lesions for female AMI patients above 75 years old are more for double-vessel disease and multi-vessel disease; the gensini integral of coronary artery stenosis degree is more among 50 to 98 points. 3. Diabetes, hypertension and age are the independent risk factors for the coronary artery lesions vessel numbers; hypertension, hyperlipidemia, diabetes, age are the independent fluence factor of coronary artery lesions degree; the risk of people who is equal or greate than 75 years old with higher vessel numbers and higher degree of coronary artery lesions is higher. |
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