| Objective: To investigate the characteristics of coronary artery stenosis in elderly women with coronary heart disease(CHD),and to retrospectively analyze the biochemical parameters,chronic history and living habits of newly diagnosed CHD patients,so as to further study the related risk factors of CHD in elderly women.To provide evidence for early intervention and effective treatment of female patients with coronary heart disease.Methods: A total of 440 female patients with suspected coronary heart disease due to chest pain in the Department of Cardiovascular Medicine,Wuhan Central Hospital from January2018 to December 2021 were consecutively collected,including 182 female patients(60-85 years old,n = 182)aged ≥ 60 years who underwent coronary angiography for the first time and were diagnosed with coronary heart disease.A total of 132 female patients(38-59 years old,n = 132)aged < 60 years who visited Wuhan Central Hospital for the first time and underwent coronary angiography for the first time and were diagnosed with coronary heart disease.In addition,126 female patients(60-91 years old,n = 126)aged≥60 years with negative coronary angiography results were used as the control group.The differences in age,blood pressure,body mass index,previous medical history and clinical examination data between the coronary heart disease group and the control group were compared.Binary logistic regression analysis was used to find the independent risk factors of coronary heart disease in women aged 60 years and above.The differences of clinical data and coronary angiography between ≥60 years old and < 60 years old were compared.For elderly women with coronary heart disease,the number of independent risk factors identified by logistic regression analysis was compared with the number of coronary artery lesions.Coronary heart disease in older women was divided into three groups using the Gensini score to compare differences in clinical biochemical parameters,respectively.Results: 1.Compared with the clinical characteristics of the elderly female CHD group and the elderly female control group,it could be concluded that the proportion of family history of hypertension,diabetes,smoking and early coronary heart disease was significantly higher than that of the negative control group,and the age,hypertension and diabetes gap was statistically significant(P < 0.05).There was no significant difference in family history of coronary heart disease and smoking between the two groups(P > 0.05).The levels of BMI,HbA1 c,and CRP in the elderly female coronary heart disease group were higher than those in the female control group,and the difference was statistically significant(P < 0.05).There was no significant difference in mean SBP and DBP values,and they were not statistically significant(P >0.05).In terms of biochemical parameters,there was no significant difference between the two groups in FBG,TC,LDL-C,TG,WBC,UA,RDW,and Fib,and there was no statistical significance(P > 0.05).2.Univariate significant clinical parameters age,hypertension,diabetes,HbA1 c,BMI,and CRP were included in multivariate logistic regression analysis after excluding collinear relationships,and the results showed that elderly women with hypertension(OR=2.034,95%CI 1.174-3.524,P=0.011),HbA1c(OR=1.363,95%CI 1.045-1.778,P=0.022),BMI(OR=1.392,95%CI 1.193-1.623,P=0.000),and CRP(OR=2.652,95%CI 1.588-4.426,P=0.000)had independent risk factors for coronary heart disease.3.Elderly female patients with coronary heart disease had a higher proportion or level of diabetes,BMI,and RDW than young and middle-aged female patients with coronary heart disease,and the difference was statistically significant(P < 0.05).Young and middle-aged female patients with coronary heart disease had higher proportion or level of hypertension and Fib than elderly female patients with coronary heart disease,and the difference was statistically significant(P < 0.05).4.Elderly female patients with coronary heart disease had 0 risk factors for single-vessel disease in 10 cases(14.1%)and 0 risk factors for multivessel disease in 2 cases(3.5%),and there were significant differences in the proportion of single-vessel disease compared with multivessel disease in the absence of risk factors(P < 0.05).Seventeen patients(23.9%)had3 and 4 risk factors for single-vessel disease,and 24 patients(42.1%)had 3 and 4 risk factors for multivessel disease.There were significant differences in the proportion of single-vessel disease compared with multivessel disease when more than 3 risk factors were present(P <0.05).5.The proportion of only single vessel disease in the young and middle-aged female coronary heart disease group was significantly higher than that in the elderly female coronary heart disease group,and there was a statistically significant difference(P < 0.05),while the proportion of three-vessel disease,involving the circumflex artery and involving the right coronary artery disease in the elderly female coronary heart disease group was significantly higher than that in the young and middle-aged group,and the difference was statistically significant(P < 0.05).The proportion of diffuse lesions and small vessel lesions in the elderly female coronary heart disease group was significantly higher than that in the young and middle-aged female coronary heart disease group,and the difference in diffuse lesions was statistically significant(P < 0.05).The proportion of drug therapy and(or)drugcoated balloon angioplasty alone in the young and middle-aged female coronary heart disease group was significantly higher than that in the elderly female coronary heart disease group and the difference was statistically significant(P < 0.05).6.WBC,RDW and EF values were different among the three groups(P < 0.05),and the trend of WBC and RDW levels increasing with the increase of Gensini score was obvious from the figure,and EF values decreasing with the increase of Gensini score.Conclusion:1.Age,hypertension,diabetes,BMI,HbA1 c and CRP in elderly women with CHD were significantly higher than those in elderly women without CHD.2.2.Hypertension,HbA1 c,BMI and CRP are independent risk factors for coronary heart disease in elderly women,and numerical levels are positively correlated with the risk of coronary heart disease.3.Elderly women with coronary heart disease have a higher proportion or level of diabetes,BMI,and RDW than young and middle-aged women with coronary heart disease.Young and middle-aged women with coronary heart disease have a higher proportion or level of hypertension and Fib than elderly women with coronary heart disease.4.The number of coronary artery lesions in elderly women with coronary heart disease is related to the number of independent risk factors,and is positively correlated.The more independent risk factors,the greater the proportion of multivessel disease.5.Elderly female patients with coronary heart disease are more likely to have three-vessel disease,circumflex artery involvement and right coronary artery involvement than young and middle-aged female patients with coronary heart disease,while the involvement of anterior descending artery disease,drug therapy and/or simple drug-coated balloon angioplasty will be less than young and middle-aged female patients with coronary heart disease.6.For elderly women with coronary heart disease,WBC and RDW levels increased with the increase of Gensini score,and EF values decreased with the increase of Gensini score. |
