国人早发冠心病的临床、生化和冠脉造影的特点(英文)

目的:探讨早发冠心病的临床、生化和冠脉造影特点。方法:经冠状动脉造影确诊的冠心病患者347例,根据年龄分为早发冠心病组(年龄45岁)95例和老年冠心病组252例(年龄55岁),以及年龄相匹配的健康对照者54例,进行冠状动脉病变、临床及生化特点回顾分析,观察是否存在差异。结果:与健康对照组相比,早发冠心病组中吸烟史、冠心病家族史、高血压及糖尿病史显著升高;高密度脂蛋白、载脂蛋白A-I明显降低,而三酰甘油、脂蛋白α和高敏C-反应蛋白水平升高。与老年冠心病组相比,早发冠心病组急性心肌梗死的发生率明显升高,病变多累及单支冠脉,而Gensini评分无显著性差异;血清高密度脂蛋白和高敏C-反应蛋白低于老年患者组。结论:吸烟、冠心病家族史、高血压及糖尿病史,高密度脂蛋白和载脂蛋白A-I降低是我国早发冠心病的主要危险因素。早发冠心病多累及单支冠脉,但病变的狭窄程度与老年冠心病患者无明显差异。

Clinical,biochemical and angiographic characteristics in Chinese patients with early-onset coronary heart disease

AIM: To investigate clinical, angiographic and biochemical features in Chinese patients with early-onset coronary heart disease (CHD). METHODS: Ninety-five consecutive patients with clinical onset of CHD at age ≤45 years, 252 patients with clinical onset of the disease at ≥55 years and 54 age-matched healthy subjects were included in the study. All patients had documented CHD according to angiography. Angiographic features, as well as clinical and biochemical risk factors, were compared between groups. RESULTS: Compared with the prevalence in healthy subjects, a higher prevalence in hypertension, diabetes, smoking history and family history of CHD was found in early-onset CHD patients. Patients ≤45 years of age had lower high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apoA-I) levels but higher triglyceride, lipoprotein(α) and high-sensitivity C-reactive protein (hsCRP) levels. Early-onset CHD showed a higher incidence of myocardial infarction and preponderance of one-vessel disease, but there were no significant differences in Gensini scores. CONCLUSION: Hypertension, diabetes, smoking, family history of CHD, high plasma triglyceride, low HDL-C levels and apoA-I are associated with early-onset CHD. The reduction of HDL-C and apoA-I may be the most important lipid risk factor in the development of early-onset CHD.