| Objective:To study the clinical characteristics and prognosis of female patients with coronary heart disease over 60 years of age.Methods:A total of 558 patients over 60 years of age in the cardiology department of the First Hospital of Jilin University were enrolled,who had been diagnosed with coronary heart disease by coronary angiography from July 2016 to December 2016.These patients were divided into female group(256 cases)and male group(302 cases).Clinical date(age,length of hospital stay,heart rate at admission,history of hypertension,smoking history and history of diabetes),laboratory test results(blood routine,liver function,blood lipid and fibrinogen)and imaging examination findings(ultrasonic cardiogram and coronary angiography)were recorded in all patients,and neutrophil to lymphocyte ratio was calculated.The above two groups of clinical features and coronary angiography results were retrospectively analyzed.According to the results of coronary angiography,the female patients were divided into single-vessel disease group(76 cases)and multi-vessel disease group(180 cases).The clinical features between the two groups were compared,and the independent risk factors for multiple vessel disease in female patients with coronary heart disease were analyzed.According to the results of coronary angiography,Gensini score was evaluated in female patients,and the correlation between Gensini score and clinical indicators(neutrophil to lymphocyte ratio,fibrinogen and left ventricular ejection fraction)was analyzed.The female patients were followed up for 12 months since they left for hospital to compare the prognosis between the single-vessel disease group and the multi-vessel disease group.The statistical analysis was conducted by using SPSS 20.0 software.Results:1.Compared with the clinical features and coronary angiography results of female group and male group,we found that the proportion of hypertension and diabetes in the female group was higher than that in the male group(P<0.05),and the proportion of smoking was lower than that in the male group(P<0.05).The levels of total cholesterol,triglyceride and low density lipoprotein cholesterol in the female group were higher than those in the male group(P<0.05),and the levels of total bilirubin,direct bilirubin and indirect bilirubin were lower than those in the male group(P<0.05).There was no statistically significant difference between the two groups in age,length of hospital stay,heart rate at admission,white blood cells,neutrophil to lymphocyte ratio,red cell distribution width,aspartate aminotransferase,alanine aminotransferase,high density lipoprotein cholesterol,fibrinogen,left ventricular ejection fraction,the number of diseased vessels and the location of diseased vessels(P>0.05).2.Compared with the clinical features of single-vessel disease group and multi-vessel disease group in female patients,we found that the level of left ventricular ejection fraction in the single-vessel disease group was higher than that in the multi-vessel disease group(P<0.05),and the levels of neutrophil to lymphocyte ratio,aspartate aminotransferase and fibrinogen were lower than those in the multi-vessel disease group(P<0.05).There was no statistically significant difference between the two groups in age,length of hospital stay,heart rate at admission,the proportion of hypertension,the proportion of smoking,the proportion of diabetes,white blood cells,red cell distribution width,alanine aminotransferase,total bilirubin,direct bilirubin,indirect bilirubin,total cholesterol,triglyceride,low density lipoprotein cholesterol and high density lipoprotein cholesterol(P>0.05).Further,neutrophil to lymphocyte ratio,aspartate aminotransferase and fibrinogen were incorporated into multi-factor Logistic regression analysis,we found that neutrophil to lymphocyte ratio was an independent risk factor for multiple vessel disease in female patients with coronary heart disease(OR=1.187,P<0.05).At the same time,the correlation between Gensini score and clinical indicators(neutrophil to lymphocyte ratio,fibrinogen and left ventricular ejection fraction)was analyzed by spearman bivariate correlation analysis.We found that Gensini score had correlation with neutrophil to lymphocyte ratio and left ventricular ejection(P<0.05),with the correlation coefficients were 0.362 and-0.298,respectively.There was no correlation between fibrinogen and Gensini score(P>0.05).Finally,the application of Kaplan-Meier survival analysis was used to compare the prognosis of 12 months of follow-up in female patients with coronary heart disease between the single-vessel disease group and the multi-vessel disease group.We found that the median survival time of multi-vessel disease group was shorter than that of single-vessel disease group(P<0.05).Conclusion:1.The proportion of hypertension and diabetes and the leves of total cholesterol,triglyceride and low density lipoprotein cholesterol in the female group with coronary heart disease over 60 years of age were significantly higher than those in the male group with coronary heart disease.The proportion of smoking and the levels of total bilirubin,direct bilirubin and indirect bilirubin were significantly lower than those in the male group with coronary heart disease.2.Neutrophil to lymphocyte ratio was an independent risk factor for multiple vessel disease in female patients with coronary heart disease over 60 years old,which was positively correlated with the severity of coronary artery disease.3.There was a negative correlation between the severity of coronary artery disease and left ventricular ejection fraction in female patients with coronary heart disease over 60 years of age.4.In female patients with coronary heart disease over 60 years of age,the prognosis of multi-vessel disease was worse than that of single-vessel disease(during 12-month follow-up). |
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