Correlation Of Blood Lipid And Homocysteine Levels With Premature Coronary Artery Disease And The Severity Of Coronary Lesions

Objective:1?To analyze the level of blood lipid and homocysteine in premature coronary artery disease and Mature coronary artery disease,coronary artery lesions,normal people;2?To explore the risk factors of premature coronary artery disease,and to analyze the correlation between the level of blood lipid and homocysteine and the severity of coronary lesions in premature coronary artery disease.Methods:A retrospective analysis was made of 268 inpatients who underwent coronary angiography for the first time in the Department of Cardiology,the second hospital of Shanxi Medical University.According to the results of coronary angiography and related definitions of premature coronary artery disease(female ? 65 years old,male ? 55 years old),they were divided into premature coronary artery disease group(85 cases),mature coronary artery disease group(85 cases),coronary arteriosclerosis group(38cases)and control group(60 cases).General data(including age,gender,smoking history,hypertension history,diabetes history,etc.)and laboratory indexes(lymphocyte,neutrophil,neutrophil/lymphocyte,monocyte,mean platelet volume,platelet distribution width,total cholesterol,triglycerides,high-density lipoprotein,low-density lipoprotein,apolipoprotein A1,apolipoprotein B,apolipoprotein A1/apolipoprotein B,apolipoprotein E,lipoprotein a,high-densitylipoprotein/cholesterol,homocysteine,small and dense low-density lipoprotein cholesterol)were collected,and the degree of coronary artery disease was evaluated by Gensini score.SPSS 25.0 was used to analyze the risk factors and severity of coronary lesions in the premature coronary artery disease.Results:1.Compared with CAL group and control group,the levels of blood lipid and Hcy in the PCAD group were higher,with statistically significant differences(P < 0.05).Person correlation analysis showed that TC(r = 0.312),LDL(r = 0.408),apoB100(r = 0.333),LPa(r = 0.296)were positively correlated with Gensini score,while Apo A1/Apo B(r=-0.269)and HDL/TC(r=-0.223)were negatively correlated with Gensini score(P < 0.05).Binary logistic regression showed that gender,smoking history,hypertension history and diabetes history were all risk factors for PCAD(P < 0.05).After eliminating these risk factors,the increase of TG(OR=1.822,95%CI:1.065?3.120,P=0.029<0.05),LPa(OR=1.028,95%CI:1.004?1.052,P=0.020<0.05),Hcy(OR=1.081,95%CI:1.024?1.141,P=0.004<0.05)and SdLDL-C(OR=1.004,95%CI:1.001?1.008,P=0.017<0.05)may be a risk factor for premature coronary artery disease.2.The ROC curve was drawn and found that the specificity and sensitivity of TG in premature coronary artery disease was 90.0% and 37.6%,respectively,and the area under the ROC curve was 0.644(95%CI: 0.555 ? 0.733,P < 0.05).The specificity and sensitivity of Hcy in premature coronary artery disease were 65.0% and 65.9%,respectively,and the area under the ROC curve was 0.687(95%CI: 0.600 ? 0.775,P <0.05).The specificity and sensitivity of SdLDL-C in premature coronary artery disease were 90.0%,35.3%,and the area under the ROC curve was 0.672(95%CI: 0.585 ? 0.759,P < 0.05).Conclusion:The risk factors of PCAD were gender,smoking history,diabetes mellitus,hypertension,abnormal lipid metabolism and hyperhomocysteinemia.TG,Hcy,SdLDL-C had predictive value for the diagnosis of premature coronary artery disease.TC,LDL,ApoB,LPa,ApoA1/ApoB,HDL/TC and crown of PCAD The degree of coronary artery disease is correlated,which has a certain guiding significance for evaluating the severity of coronary artery disease.TC,LDL,Apo B,LPa,Apo A1/Apo B,HDL/TC in PCAD patients are correlated with the degree of coronary artery lesion,which has certain guiding significance for the assessment of the severity of coronary artery lesion.