The Morphological Mechanism Of Diffuse Plaque Formation In Coronary Atherosclerosis And Its Correlation With Age

ObjectiveTo investigate the morphological mechanism of diffuse plaque formation in patients with coronary artery disease(CHD)and the association between coronary diffuse lesions and age.MethodsWe selected 93 patients with CHD.According to the results of intravascular ultrasound(IVUS),41 patients were divided into diffuse plaque group and 52 patients with non-diffuse plaque.The general clinical data of the two groups were compared,and further divided into three subgroups of middle-aged(age?59 years old),the young old(60-74 years old)and the advanced old(age?75 years old),Arterial plaques and remodeling patterns were statistically analyzed.Statistical analysis was performed using SPSS 24.0 statistical software.Quantitative data were described as (?)±s,two independent samples t-test were used between the two groups,and comparison between groups was performed by analysis of variance.Count data were described as percentage,using?~2 or Fisher's exact test.Correlation analysis was used to analyze the bivariate relationship.Logistic regression test was used to analyze the relationship between diffuse plaque and various factor variables.Results1.Comparison of basic clinical data:The proportion of hypertension,diabetes,and negative remodeling and age in the diffuse plaque of the coronary artery was significantly higher than that in the non-diffuse lesion group(P<0.05).2.Comparison of diffuse plaque and negative remodeling in different age groups:The proportion of diffuse plaques in the three age groups was statistically significant(P<0.05).The proportion of diffuse plaques in the older group was highest among 3 groups(P<0.05).Compared with the young and middle-aged group,the proportion of diffuse plaque in the elderly group was significantly higher(P<0.05).There was no significant difference in the proportion of negative remodeling between the three groups(P>0.05).3.Comparison of parameters between the proximal reference segment,the narrowest point and the distal reference segment of the diffuse plaque3.1 Comparison of Plaque CSA:The difference of Plaque CSA between the three sites was significant(P<0.01),and the difference between each two groups was significant(P<0.001);3.2.Comparison of PB:The difference in PB between the three sites was statistically significant(P<0.001),and the difference between each two groups was statistically significant(P<0.001);3.3.Comparison of lumen CSA:There was a statistically significant difference in lumen cross-sectional area between the three sites(P<0.001).There was no significant difference in lumen CSA between the proximal and distal reference segments(P>0.05).3.4.Comparison of EEM CSAThere was a statistically significant difference in lumen cross-sectional area between the three sites(P<0.001).The EEM CSA between the proximal and distal showed statistically significant difference(P<0.001).There was no significant difference in lumen cross-sectional area between the reference segments(P>0.05).3.5.Correlation analysis of parameters between the proximal reference segment,the narrowest part and the distal reference segment of the diffuse plaqueThe plaque CSA of the proximal and distal reference segments were positively correlated(r=0.81,P=0.00);PB was positively correlated between the two sites(r=0.6,P=0.000);lumen CSA between the two sites positively correlated(r=0.4,P=0.018);no significant correlation between EEM CSA between the two sites(P>0.05)4.Regression analysis of factors related to diffuse plaque formationMultivariate logistic regression analysis showed that age(OR=1.150)and negative remodeling(OR=4.950)were risk factors for diffuse plaque formation(P<0.05).Logistic regression analysis of the LR progressive screening of independent variables showed that age(OR=1.162)and negative remodeling(OR=5.515)were independent risk factors for diffuse plaque formation,both of which were statistically significant(P<0.05).There was no significant difference in diabetes and hypertension(P>0.05).Conclusions1.Age is an independent risk factor for diffuse plaque in the coronary arteries.Older patients are at greater risk of developing diffuse coronary artery disease,posing a challenge to revascularization.2.The development of diffuse plaque is related to the stenostic leisons.The atherosclerosis in the reference segments affects the assessment of vascular remodeling.The diffuse lesions are associated with negative remodeling.