| Objectives 1 By analyzing the images of patients with anomalies origin of coronary artery(AOCA)on Coronary Computed Tomography Angiography(CCTA),AOCA was typed to elucidate the coronary origin of abnormal origin.Whether the arteries are associated with the production of atheromatous plaques;2 The difference in the incidence of plaque between the different types of coronary artery abnormalities and the internal coronary arteries;3 Which type of AOCA is more dangerous.Methods 1 Collect patients with abnormal origin of coronary artery detected in our hospital from September 2016 to March 2019,and remove patients with high risk factors of ACS(Congenital heart disease,high blood pressure,high blood fat,long-term smoking,diabetes,obesity,clear family history of early onset coronary heart disease,etc.),then divided into a group.A total of 65 patients,42 males and 23 females,with an average age of 57.62±9.233 years,were divided into AOCA group.A total of 65 patients,42 males and23 females,mean age 57.62±9.233 years,were divided into AOCA group.Patients with normal coronary arteries from the left and right coronary sinus were collected and grouped into one group(use the same exclusion criteria as the AOCA group),A total of 65 cases,42 males and 23 female,mean age 59.95±5.691.Results 1 AOCA group,42 men,23 women,mean age 57.62±9.233 years,the normal group,42 men,23 women,mean age 59.95±5.691 years,t=1.738,P=0.085,P>0.05.65 patients in the AOCA group,AS positive in 46 cases,AS negative in 23 cases,the positive rate was 70.08%;In the normal group of 65 patients,AS was positive in 30 cases and negative in 35 cases,with a positive rate of 46.15%.c~2=8.109,P=0.004,<0.05.2 In the AOCA group,43 cases had abnormal origin of the left coronary artery,2 4 cases were positive in AS,the positive rate was 79.08%,24 cases had abnormal origin of right coronary artery,12 cases were positive in AS,and the positive rate was 50.00%.In the 65patients,27 patients with left coronary artery AS were positive,the positive rate was41.54%,and the right coronary artery was positive for 12,the positive rate was 18.46%,c~2=39.296,P=0,P<0.05.3 In the ACOA group,the coronary artery originated from 41cases outside the coronary sinus,29 cases were positive in AS,and 12 cases were negative in AS,with a positive rate of 70.07%;It originated from 18 cases of unsuitable coronary sinus,AS positive 11 and negative 7 cases,the positive rate was 61.11%;1 case of single coronary artery,0 case of AS positive,1 case of negative,the positive rate was 0%;There were 6 cases of left main trunk and 6 cases of AS positive,and the positive rate was100%;c~2=5.558,P=0.135,>0.05(One patient had an AOCA originating from the coronary sinus originating from the coronary artery and originating from an inappropriate coronary sinus).2 In the AOCA group,there were 43 cases of abnormal origin of the left coronary artery,34 cases of AS positive,the positive rate was 79.07%,24 cases of right coronary arteryabnormality,12casesofAS positive,and thepositive ratewas50.00%.c~2=6.049,P=0.014,<0.05(In 2 cases,both the left and right coronary arteries have abnormal origins).The coronary artery originated from the coronary sinus,31 cases of left coronary artery abnormality,24 cases of AS positive,the positive rate was 77.42%,11cases of right coronary origin abnormality,5 cases of AS positive,the positive rate was45.45%.c~2=3.882,P=0.049,P<0.05;Originated from unsuitable coronary sinus type,6cases of left coronary origin abnormality,4 cases of AS positive,positive rate 66.57%,12cases of right coronary origin abnormality,AS positive 7,positive rate 58.33%,P=1,P>0.05.AOCA group of 18 patients coronary sinus origin inappropriate cases,There were 5cases of vascular opening in a gap,10 cases of proximal lumens were close to the myocardium and aorta,and patients had chest tightness and hernia symptoms.(The group of patients with no moderate or severe stenosis),Other types of AOCA have no obvious symptoms except for moderate and severe stenosis,and the lumen is safe.Conclusions 1 The incidence of plaques on varicose vessels in AOCA patients is higher than that in normal population,Patients with AOCA have a higher risk of developing CAD and ACS.2 There was no significant difference in the incidence of 4 types of plaques,but the incidence of plaques in the left coronary artery with abnormal origin was higher.4 Among the four types of AOCA,only originated from the unsuitable coronary sinus type,the condition other than stenosis caused by plaque caused by the variation of coronary opening and walking is the most dangerous in type 4 AOCA.Figure11;Table9;Reference 110. |
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