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Objective:To analyze the risk factors of patients with ankylosing spondylitis (AS) combined with premature coronary atherosclerotic heart disease (PCAD).Methods:A total of 74 patients with AS and coronary atherosclerotic heart disease (CAD) in Peking Union Medical College Hospital from January 1983 to July 2021 were enrolled. According to the age of onset of coronary heart disease, the 74 patients were divided into PCAD group and NPCAD (non-premature coronary heart disease) group. T test and Chi square test were used to analyze the data of the two groups, the risk factors for AS-PCAD were analyzed by multivariate Logistic regression. Results:① There were 37 cases in the PCAD group and 37 cases in the NPCAD group. In the PCAD group, there were 28 men and 9 women; wherease all were men in the NPCAD group. The difference was statistically significant ( χ2=10.25, P=0.001). ② Compared with the NPCAD group, the age of AS-PCAD group was younger [(23±10) years vs (29±12) years, t=-2.28, P=0.026], and the course from AS to CAD was shorter [(25±10) years vs (34±13) years, t=-3.00, P=0.004], hemoglobin (Hb) level was lower [(122±23) g/L vs(132±18) g/L, t=2.10, P=0.039], rate of anemia was higher [38.5%(14/37) vs 16.2%(6/37), χ2=4.39, P=0.037]. Proportion of increased C-reactive protein (CRP) was higher [65.5%(19/29) vs 35.5%(11/31), χ2=5.41, P=0.019]. ③ Juvenile onset AS (JoAS)[ OR(95% CI)=3.45(1.31, 9.10), P=0.012] and high levels of CRP [ OR (95% CI)=3.68 (1.44, 9.40), P=0.006] might berisk factors of AS-PCAD by multiple logisctic regression analysis. Conclusion:Patients with AS have a higher probability of PCAD, especially in those patients with JoAS, persistent inflammation and anemia. It is necessary to be alert to the risk of PCAD and early screening.
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Objective: To explore the related factors of premature acute myocardial infarction(AMI), and to compare the the long-term outcomes in patients with and without premature AMI after percutaneous coronary intervention (PCI). Methods: This study was a prospective cohort study.From January 2013 to December 2013, 10 724 consecutive patients with coronary heart disease undergoing PCI in Fuwai Hospital were enrolled. Among them 1 920 patients with the diagnosis of AMI were divided into two groups: premature AMI (man≤50 years old, woman≤60 years old) and non-premature AMI. The baseline characteristics were collected, and multivariate logistic regression was uesed to analysis the related factors of premature AMI. The clinical outcomes, including the major adverse cardiovascular and cerebrovascular events(MACCE) which was the composite of cardiac death, myocardial infarction, revascularization, stroke and stent thrombosis, as well as bleeding events, during hospitalization, at 2 years and 5 years follow-up were analyzed. Results: A total of 1 920 AMI patiens were included(age was (56.5±11.3) years old)，with 1 612(84.0%) males. There were statistically significant differences between the two groups in gender, body mass index, blood lipid, complications, inflammatory markers, etc (all P<0.05). Multivariate logistic regression analysis showed body mass index(OR=1.06, 95%CI 1.01-1.10, P<0.01), triglyceride(OR=1.47, 95%CI 1.14-1.90, P<0.01), serum uric acid level(OR=1.02, 95%CI 1.01-1.04, P<0.01), high density lipoprotein cholesterol level(OR=0.33, 95%CI 0.14-0.78, P=0.01) and history of hypertension(OR=0.72, 95%CI 0.56-0.93, P=0.01) were independent related factors of premature AMI. The incidence of all-cause death and cardiac death were lower during hospitalization, at 2 years and 5 years follow-up in the premature AMI group than in non-premature AMI group(all P<0.05). In the premature AMI group, the incidence of MACCE and stroke was lower, with more bleeding events in 5 years follow-up(all P<0.05). Conclusions: Metabolic abnormalities, including high BMI, high triglyceride level and high serum uric acid, low high-density lipoprotein cholesterol level are the related factor of premature AMI. The incidence of ischemic events in patients with premature AMI is lower, while the incidence of bleeding events is higher than non-premature AMI patients.
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Aged , Female , Humans , Male , Middle Aged , Coronary Artery Disease , Myocardial Infarction , Percutaneous Coronary Intervention , Prospective Studies , Risk Factors , Treatment Outcome , Uric AcidABSTRACT
Objective To investigate the relationship between aldehyde dehydrogenase 2 (ALDH2) gene polymorphism and premature coronary heart disease (CHD) in Chinese Han population.Methods A total of 505 patients were enrolled in the present study.Of them,375 were definitely diagnosed as CHD and another 130 were excluded from CHD by coronary angiography.Coronary heart disease patients were divided into premature coronary heart disease (male ＜55 years,female ＜65 years) group (n=150) and late onset coronary heart disease (male ≥ 55 years,female ≥ 65 years) group (n=225);According to whether after drinking flushing,the enrolled 505 patients were divided into alcohol flushing syndrome(AFS) group (n=135) and no AFS group (n=370);According to whether used to drinking,they were divided into accustomed to drinking group (n=189) and no drinking custom group (n=316).The ALDH2 gene polymorphism was analyzed by sanger sequencing.Results There was no significant difference in the distribution ofALDH2 genotype between the patients with premature CHD and late-onset CHD,also between CHD and non-CHD (P＞0.05).The logistic regression analysis showed that ALDH2 gene was not a predisposing factor of PCHD and CHD after adjusting for gender,age,smoking,drinking,body mass index (BMI),hypertension,diabetes,hyperlipidemia and family history of CHD (P=0.729,OR=1.098,95％CI 0.648-1.859;P=0.581,OR=1.156,95％CI 0.692-1.930).The incidence of ALDH2 mutant (GA+AA) was significantly higher in AFS group than in no AFS group (67.4％ vs.10.5％,P＜0.01).The gene mutation frequency was markedly higher in no drinking custom group than in accustomed to drinking group (29.7％ vs.19.1％,P＜0.01).Conclusions No obvious correlation exists between ALDH2 gene polymorphism and the incidence of premature CHD or the onset of CHD in Chinese Han population.There is a certain relationship between ALDH2 mutant gene and AFS.
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Objective To investigate the red blood cell distribution width (RDWC)and serum leptin (Leotin)levels in pa-tients with early onset coronary heart disease (CHD)and their correlation.Methods From January 2013 to April 2016,320 cases of hospitalized patients with chest pain,chest tightness in the cardiovascular department of the Gaoming District People's Hospital of Foshan City,Guangdong Province,were examined by coronary artery.Of which 240 cases were male under 55 years old,female under 65 years old patients with coronary heart disease (coronary heart disease group),another 80 cases of normal coronary angiography and treadmill negative males under 5 5 years old,female under 6 5 years old patients,as the con-trol group.Gensini score in patients with premature coronary heart disease was calculated according to the coronary artery imaging results,Comparison between the two groups of red blood cell distribution width and serum leptin levels were differ-ent,analysis of red blood cell distribution width and serum leptin levels and the correlation between the degree of coronary artery lesions.Results The red blood cell distribution width and the serum leptin level in patients with early onset coronary heart disease were (13.87 ± 0.31)% and (12.24 ± 2.21)μg/L,significantly higher than the control group (14.31 ± 0.22)% and (9.21±1.78)μg/L (t=11.742,11.116,P<0.001).And Gensini score was positively correlated with coro-nary artery (r=0.413,0.124,P=0.000,0.041).Correlation of red cell distribution width and serum leptin levels were posi-tively (r=0.107,P=0.008).The research object curve the predictive value of red cell distribution width in patients with premature coronary heart disease (ROC)analysis showed that the area of ROC curve of red cell distribution width (AUC) under 0.725(95%CI:0.679~0.764),red cell distribution width value 12.85%,the sensitivity was 68.1%,specificity was 65.4%.Conclusion In patients with premature coronary heart disease,the red blood cell distribution width and serum leptin levels were significantly increased,and was positively correlated with the degree of coronary artery disease,can be used as an independent predictor of premature coronary heart disease.
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Objective To research photoelectric facial blood flow volume characteristic of premature coronary heart disease of heart blood stasis syndrome (HBSS) and phlegm syndrome (PS), and its relation with NO and ET. Methods Patients of premature coronary heart disease of HBSS (36 cases) and PS (35 cases) were selected, with 31 health people as control. The parameter of photoelectric facial blood flow volume was detected with GD-3 photoelectric blood stream plethysm (PBSP) of the facial color-diagnosis. NO was determined by nitrate reductase method and ET was determined by RIA. Results Hb, He, Hf, Hb/Tab and Hf/Hb of HBSS decreased obviously compared with the control (P