The Research Of Clinical Characteristics And Six-month Follow-up In Patients With Premature Acute Coronary Syndrome

Objective The retrospective study was designed to investigate the risk factors and the features of the coronary artery lesions in patients with premature acute coronary syndrome(PACS),as well as to assess short-term prognosis and medication compliance situation in patients with PACS after PCI during the six-month follow-up period.Materials and Methods A total of 414 patients who had hospitalized for coronary angiography(CAG)and been first diagnosed with ACS,were divided into PACS group(male ? 55 years old,female ? 65 years old,n = 168)and control group(male ? 55 years old,female ? 65 years old,n = 246)in our institution from December 2014 to April 2016.The detail history,the basic clinical data and the characteristics of the coronary artery lesions were compared.In addition multivariable logistic regression was used to analyze the main risk factors of PACS.Meanwhile the incidence of major adverse cardiovascular events(MACEs)during hospitalization and follow-up period,the situation of short-term prognosis and medication compliance were analysed and compared detailedly through the observation in patients with ACS after PCI.Results 1.Compared with the control group,more incentives were found in PACS group.The ratios of male,smoking,obesity and family history of coronary heart disease(CHD)were also significantly higher than those in control group.Howere,the incidence of hypertension and diabetes were less than those in old patients(P < 0.05).The level of low-density lipoprotein cholesterol(LDL-C)and plasma fibrinogen(FIB)were higher in PACS group(P < 0.05).The other assay index in the distribution of statistic were not significant between the two groups.By comparison,there was no significant difference in the distribution of the main risk factors between the two groups.The distribution ratio of patients in the two groups who had risk factors greater than or equal to three,were significantly higher than that who had less than three risk factors.2.Multiple factor logistic analysis revealed that male,history of CHD,obesity,the level of FIB and LDL-C were independent risk factors of PACS.3.Compared with the control group,there was more single-vessel and localized lesions in PACS group,with more thrombus burden,with less calcification and collateral circulation(P < 0.05);but there was no significantly difference in the culprit vessel position(P > 0.05).The proportion of patients received PCI in hospital in PACS group was statistically higher than that in control group,nevertheless there was no difference between the two groups in terms of the choice of emergency PCI or elective PCI(P > 0.05).4.The observation in patients with ACS after PCI,revealed that the incidence of MACEs in ACS group was significantly lower than that in control group during hospitalization or follow-up period.Meanwhile during the follow-up period,the drug compliance were similar between the two groups,but they were both lower than that during hospitalization period respectively(P < 0.05).Conclusion 1.Compared with the control group,Male,smoking,obesity,history of CHD,the levels of LDL-C and FIB are major risk factors in patients of PACS.They mostly have explicit incentives and a risk factor clustering phenomena existed.2.Compared with the control group,there was more single-vessel and localized lesions in PACS group,with more thrombus burden,with less calcification and collateral circulation,with more proportion of PCI,with more favorable short-term prognosis.3.During the six-month follow-up period,the drug compliance are similar between the two groups,but they are both lower than that during hospitalization period respectively.