Correlation Between Progression Of Coronary Non-criminal Lesions And Its Risk Factors In Patients With Coronary Heart Disease

Objective Retrospectively analyze the correlation between the progression of non-culprit coronary lesions(NCCL)and related risk factors in patients with coronary heart disease.Methods Patients were diagnosed as coronary heart disease and received secondary prevention at the Affiliated Zhzongshan Hospital of Dalian University were selected From August 2010 to November 2019.All patients got at least twice coronary angiography(CAG)examination.The interval between first and review CAG were not less than 10 months.We used quantifying coronary angiography(QCA)to analyze CAG image.The quantifying coronary angiography software we used was the syngo XWP from Siemens in the Netherlands.According to the definition of NCCL progress:?10%diameter reduction of a pre-existing stenosis?50%;?30% diameter reduction of a pre-existing stenosis<50%;development of a new stenosis?30% diameter reduction in a segment that was normal at the first diagnostic CAG;progression of any lesion to total occlusion at the review CAG;progression of vascular stenosis was found to be less than10% when review CAG but needed to received PCI treatment[1],patients were divided into NCCL progression group and NCCL non-progression group.We used SPSS 20.0.0to analyze the basic characteristics of the patient,general clinical data,and follow-up data.The follow-up methods included clinic review,inpatient review and telephone visits.The content of the follow-up includes the detailed used of statins,whether there is a missed dose of statins,and calculate the proportion of days covered(PDC)of statin use during the first CAG and review CAG.PDC?80% is good for statin compliance,PDC <80% is poor for statin compliance[2].All possible related factors were received spearman correlation analysis.Selected all factors related to NCCL progression into the binary logistic regression analysis.We analyzed the correlation between each factors and progression of NCCL in patients with coronary heart disease.Then we discuss the effects of factors for progression of NCCL in patients with coronary heart disease.Result A total of 436 patients were selected for this study,including 327 male patients(75.0%)and 109 female patients(25.0%),aged 30-89(64.64 ± 10.34)years old.According to QCA results,160 patients(36.7%)were included in NCCL progression group,and 276 patients(63.3%)were included in non-progressive NCCL group.Between NCCL progression group and non-progressive NCCL group,age,gender,interval between first and review CAG,exposure to traditional risk factors(smoking,hypertension,diabetes,fasting blood glucose level of diabetics),triglyceride level,total cholesterol level,apolipoprotein B100 level were no significant differences(p>0.05).Serum creatinine level(80.03±31.16vs73.72±21.88,p=0.014),uric acid level(377.56±99.75vs357.35±89.55,p=0.021),low-density lipoprotein cholesterol level(2.25±0.97vs2.02±0.82,p=0.009)and poor statin compliance(35.3%vs18.2%,p<0.001)in NCCL progression group was significantly higher than those in NCCL non-progressive group.High-density lipoprotein cholesterol level(1.13±0.26vs1.21±0.32,p=0.014),apolipoprotein A1 level(1.06±0.27 vs1.12±0.27,p=0.022),and ratio of apolipoprotein A1 to apolipoprotein B100(1.35±0.53vs1.48±0.54,p=0.019)in NCCL progression group were significantly lower than those in NCCL non-progressive group.According to spearman correlation analysis,Interval of first to review CAG(r=0.103,p=0.032),low-density lipoprotein cholesterol level(r=0.124,p=0.010),poor statin compliance(r=0.180,p<0.001)were positively correlated with NCCL progression in patients with coronary heart disease;Apolipoprotein A1 level(r=-0.117,p=0.014),ratio of apolipoprotein A1 to apolipoprotein B100(r=-0.125,p=0.009)were negatively correlated with NCCL progression in patients with coronary heart disease.A binary logistic regression analysis was performed on all factors related to NCCL progression found that the apolipoprotein A1 level OR = 0.274 [95% CI(0.084-0.900)],p = 0.033;poor statin compliance OR =1.901 [95% CI(1.054-3.429)],p = 0.033.Conclusion 1.Low-density lipoprotein cholesterol level was positively correlated with NCCL progression in patients with coronary heart disease.Apolipoprotein A1 level and ratio of apolipoprotein A1 to apolipoprotein B100 were negatively correlated with NCCL progression in patients with coronary heart disease.Low apolipoprotein A1 level was independently correlated with NCCL progression in patients with coronary heart disease.2.Poor statin compliance was the independent risk factor of NCCL progression in patients with coronary heart disease.