ABSTRACT
Objective: To clarify correlation between lipoprotein subfraction and different age of coronary heart disease. Methods: A total of 1217 patients with coronary angiography (CAG) confirmed CAD were consecutively enrolled. According to onset age, the patients were divided into 3 groups: Very early CAD group, n=135 patients, ≤45 years, Early CAD group, n=505 patients, male at (45-55) years and female at (45-65) years, Late CAD group, n=577 patients, male>55 years and female>65 years. Meanwhile, there was a Control group, n=72 subjects, ≤45 years with normal CAG. The Lipoprotein system was used to classify lipoprotein subfractions and to analyze the distributions of different particles of high-density lipoprotein (HDL) subfraction and low-density lipoprotein (LDL) subfraction in above 4 groups; to explore the relationship between HDL subfraction and very early CAD occurrence. Results: Compared with other groups, Very early CAD group had decreased large particle of HDL subfraction and increased small particle of LDL subfraction, P<0.05. Logistic regression analysis found that the large particle of HDL subfraction was negatively related to very early CAD occurrence (OR=0.872, 95% CI 0.825-0.922), small particle of LDL subfraction was positively related to very early CAD occurrence (OR=1.038, 95% CI 1.008-1.069). Further multivariate Logistic regression analysis indicated that only large particle of HDL subfraction was obviously negatively related to very early CAD occurrence (OR=0.899, 95% CI 0.848-0.954). Conclusion: Large particle of HDL subfraction was negatively related to very early CAD occurrence which implied it played an important role in very early CAD process.
ABSTRACT
Objective: To establish a scoring system for predicting the risk of side branch occlusion(SBO) in coronary bifurcation intervention based on visual estimation of quantitative coronary angiography (QCA). Methods: RESOLVE scoring system was developed from QCA. A total of 1545 patients with 1601 bifurcation lesions by RESOLVE study were enrolled. Based on RESOLVE scoring system, visual estimation was conducted to compare the consistency. According to SBO occurrence after main branch stent implantation, our research was divided into 2 groups: SBO group, which was defined by coronary angiography confirmed TIMI grade decreasing, n=114 patients with 118 lesions and Non-SBO group, n=1431 patients with 1483 lesions. Using RESOLVE scoring method as reference,V-RESOLVE scoring system was established, the discrimination, goodness-of-fit and V-RESOLVE score for the incidence of SBO were assessed;the diagnostic value for predicting the risk of SBO in coronary bifurcation intervention was compared between 2 scoring systems. Results: The consistency between visual and QCA was from fair to moderate (weighted Kappa=0.22-0.44). Compared with Non-SBO group, SBO group had the higher degrees of pre-operative bifurcation stenosis and side branch stenosis before main branch stent implantation; larger bifurcation angle and vessel diameters in main/side branches, all P<0.01. The area of V-RESOLVE under ROC curve was 0.76(95%CI 0.71-0.81) which was similar to the area of RESOLVE under ROC curve:0.77 (95% CI 0.72-0.81), P=0.74, Hosmer-Lemeshow P=0.17. The patients were categorized into 2 conditions by V-RESOLVE: high risk (V-RESOLVE score≥12)and non-high risk (V-RESOLVE score<12), the incidence of SBO was higher in high risk patients (16.7% vs 4.3%), P<0.01. The incidences of SBO were similar in non-high risk patients by V-RESOLVE and RESOLVE (4.3% vs 3.4%), P=0.22 and in high risk patients (16.7% vs 18.0%), P=0.60. Conclusion: V-RESOLVE scoring system may predict the risk of SBO in patients with coronary bifurcation intervention.