Analysis Of Risk Factors Of Triple-vessel Coronary Artery Disease

BackgroundCoronary heart disease is one of cardiovascular diseases with high morbidity and mortality,furthermore triple-vessel coronary artery disease is the type that has highest risk of death and adverse events in coronary heart disease.Percutaneous coronary intervention(PCI)or coronary artery bypass grafting(CABG)can improve the prognosis of triple-vessel coronary artery disease patients,but currently awareness and treatment rate of coronary heart disease are generally low.Studying the risk factors of triple-vessel coronary artery disease can promote identifying high-risk groups,which subsequently are diagnosed and treated by limited medical resources.It is well known that the relationship between traditional risk factors(including advanced age,male,family history of coronary heart disease,hypertension,dyslipidemia,diabetes,smoking,obesity,etc.)and the occurrence and prognosis of coronary heart disease is clear,but previous studies have found the relationship between traditional risk factors and triple-vessel coronary artery disease is not consistent.Some studies have shown that the risk factors of triple-vessel coronary artery disease in different regions may be different.At present,there are few reports on the risk factors of triple-vessel coronary artery disease in Shandong.Objective(1)To study the risk factors of triple-vessel coronary artery disease,which can provide a theoretical basis for early intervention to reduce the incidence of triple-vessel disease.(2)To study the influencing factors of the hospital stay length in patients with triple-vessel coronary artery disease,which can help guide the rational and efficient use of medical resources.MethodsThe data of coronary angiography patients from Qilu Hospital of Shandong University from January 2013 to Aprnl 2017 were analyzed.Unconditional logistic regression was used to analyze the risk factors of triple-vessel coronary artery disease.Multiple linear regression was used to analyze the influencing factors of the hospital stay length.Results(1)A total of 4497 cases were included in the study,including 2879 cases of non-triple-vessel disease group and 1618 cases of triple-vessel disease group.There were statistical differences in gender,age,hypertension history,diabetes history,drinking history,Red blood cell distribution width(RDW),Total bilirubin(TBIL),Direct bilirubin(IBIL),Creatinine(Cr),Total cholesterol(TC),Trnglyceride(TG),High density lipoprotein cholesterol(HDL-c),Low density lipoprotein cholesterol(LDL-c),Homocysteine(Hcy),and Fibrinogen(FIB).Triple-vessel disease was used as the dependent variable,and the above indicators were used as independent variables for unconditional logistic regression:male,age,hypertension history,diabetes history,RDW,TC,LDL-c,Hcy,and FIB were positively correlated with triple-vessel disease.Drinking history,TBIL,and HDL-c were negatively correlated with triple-vessel disea,e.(2)Among all male patients(3036 cases),there were statistical differences in age,hypertension history,diabetes history,drinking history,RDW,TBIL,IBIL,TC,TG,HDL-c,LDL-c,and FIB between non-triple-vessel disease group(1897 cases)and three-vessel disease group(1139 cases).Triple-vessel disease was used as the dependent variable,and the above indicators were used as independent variables for unconditional logistic regression:age,hypertension history,diabetes history,RDW,TC,LDL-c,and FIB was positively correlated with triple-vessel disease.Drinking history,TBIL and HDL-c were negatively correlated with triple-vessel disease.(3)Among all female patients(1461 cases),there were statistical differences in age,hypertension history,diabetes history,smoking history,drinking history,Cr,TC,TG,LDL-c,Hcy,BUN,APTT,and FIB between non-triple-vessel disease group(982 patients)and triple-vessel disease group(479 patients).Triple-vessel disease was the dependent variable,and the above indicators were used as independent variables for unconditional logistic regression:age,diabetes history,Hcy,FIB were positively correlated with triple-vessel disease.(4)Among all elderly patients(age?60 years,2577 cases),there were statistical differences in gender,hypertension history,diabetes history,RDW,TBIL,Cr,HDL-c,LDL-c,Hcy,UA,and FIB between non-triple-vessel disease group(1040 cases)and triple-vessel disease group(1537 cases).Triple-vessel disease was used as the dependent variable,and the above indicators were used as independent variables for unconditional logistic regression:male,hypertension history,diabetes history,RDW,LDL-c,Hcy and FIB were positively correlated with triple-vessel disease,and TBIL and HDL-c were negatively correlated with triple-vessel disease.(5)Among all hypertensive patients(2611 patients),there were statistical differences in gender,age,diabetes history,RDW,TBIL,HDL-c,LDL-c,Hcy,and FIB between non-triple-vessel disease group(1594 patients)and triple-vessel disease group(1017 patients).Triple-vessel disease was used as the dependent variable,and the above indicators were used as independent variables for unconditional logistic regression:male,age,diabetes history,RDW,LDL-c,and FIB were positively correlated with triple-vessel disease.HDL-C was negatively correlated with triple-vessel disease.(6)Among all diabetic patients(1148 cases),there were statistical differences in gender,age,hypertension,RDW,and FIB between the non-triple-vessel disease group(639 patients)and the triple-vessel disease group(509 patients).Triple-vessel disease was used as the dependent variable,and the above indicators were used as independent variables for unconditional logistic regression:male,age,RDW,and FIB were positively correlated with triple-vessel disease.(7)Among all smokers(2177 patients),there were statistical differences in gender,age,hypertension history,diabetes history,drinking history,RDW,Cr,TC,HDL-c,LDL-c,Hcy,and FIB between non-triple-vessel disease group(1408 patients)and triple-vessel disease group(769 patients).Triple-vessel disease was used as the dependent variable,and the above indicators were used as independent variables for unconditional logistic regression:male,age,hypertension history,diabetes history,LDL-c,and FIB was positively correlated with triple-vessel disease,and drinking and HDL-c were negatively correlated with triple-vessel disease.(8)Among all drinking patients(1828 cases),there were statistical differences in gender composition,age,hypertension history,diabetes history,RDW,Cr,TC,HDL-c,LDL-c and FIB between non-triple-vessel disease group(1213 cases)and triple-vessel disease group(615 cases).Triple-vessel disease was used as the dependent variable,and the above indicators were used as independent variables for unconditional logistic regression:male,age,hypertension history,diabetes history,RDW,and TC were positively correlated with triple-vessel disease.HDL-c was negatively correlated with triple-vessel disease.(9)Hospital stay length of coronary heart disease inpatients was positively correlated with medical insurance,admission diagnosis,medicinal history of ticagrelor,and angiographic diagnosis.Hospital stay length of coronary heart disease inpatients was negatively correlated with the history of aspirin medication,clopidogrel medication history,and statin medication history.(10)Hospital stay length of triple-vessel disease inpatients was positively correlated with the admission diagnosis and the history of angiotensin II receptor blocker medication.Hospital stay length of triple-vessel disease inpatients was negatively correlated with the history of clopidogrel and the history of beta-blockers.ConclusionMale,aging,hypertension history,diabetes history,high RDW,abnormal lipid metabolism,high FIB are risk factors for triple-vessel disease;moderate alcohol consumption,high TBIL,high HDL-c are protective factors.Male,advanced age,diabetes,red blood cell distribution width,fibrinogen are the main factors predicting triple-vessel disease.Admission diagnosis,medication history(including clopidogrel,ARB,and beta-blockers)are influencing factors of hospital stay length of triple-vessel disease inpatients.