Correlation Between Clinical Features Of Acute Myocardial Infarction And Severity Of Coronary Artery Disease In Young Women

Objective:To analyze the clinical features of young women with acute myocardial infarction(AMI).And to investigate the relations between risk factors and the severity of coronary lesions.Methods:Clinical and coronary angiographic features were compared respectively between case group(women with AMI,age?44 years,N=47)and control groups(men with AMI,age?44 years,N=141;women with AMI,age?65 years,N=141).All patients were admitted to Fu Wai Hospital from January 2013 to September 2016.Gensini score(GS score)were used to evaluate coronary angiographic features.These young women with AMI were classified into three groups according to the tertile of the GS score(low GS score,GS score<19,n=17;intermediate GS score,19?GS score,36,n=15;high GS score,GS score>36,n=15),and their clinical features were compared.Logistic regression analysis and receiver operating characteristic(ROC)curve were used to evaluate the efficacy of risk factors in predicting high GS score.And the correlations between continuous variables and GS score were evaluated by spearman rank analysis.Results:Prevalence of somking and levels of Body Mass Index(BMI)?serum creatinine?serum uric acid were significantly lower while the level of high density lipoprotein cholesterol(HDL-C)were significantly higher in young women group than in young men group(p<0.05).Prevalence of hypertension and levels of glycosylated hemoglobin?cholesterol?low density lipoprotein cholesterol(LDL-C)were significantly lower while the level of HDL-C were significantly higher in young women group than in elderly women group(p<0.05).Compared with young men,young women with AMI had a significantly lower GS score(p<0.05).Meanwhile,compared with control groups,young women with AMI had a higher proportion of patients who had a GS score of 0.As for young women with AMI,compared with low GS score group,high GS score group had significantly higher levels of cholesterol and LDL-C(p<0.05).And the level of hs-CRP was significantly higher in high GS score groups than in intermediate GS score group and low GS score group(p<0.05).Multivariate logistic regression analysis showed that hs-CRP was an independent risk factor for high GS score in young women with AMI.For hs-CRP,ROC curve analysis showed that the area under curve was 0.791(95%CI:0.643-0.938),with an optimal cut-off value of 2.14mg/L(sensitivity:86.7%,specificity:75%)in predicting high GS score.Moreover there were positive and significant correlation between BMI(r=0.300,p=0.040),serum uric acid(r=0.293,p=0.047),hs-CRP(r=0.402,p=0.005),triglyceride(r=0.336,p=0.021),cholesterol(r=0.439,p=0.002),LDL-C(r=0.393,p=0.006)and GS score for young women with AMI.Conclusion:Young women with AMI have less and milder atherosclerotic risk factors and have less severe coronary lesions than control groups.Hs-CRP is a valuable predictor for the severity of coronary lesions in young women with AMI.