Comparative analysis of clinical manifestations and coronary arteriography of coronary heart disease / 中华老年医学杂志

ABSTRACT

Objective To evaluate the diagnostic significance of ECG and coronary arteriography (CAG) in coronary heart disease in different age groups. Methods totally 216 cases of suspected or CAG-confirmed coronary heart disease were retrospectively analyzed. The non-elderly group included patients aged 45-59 years, and the elderly one was older than 60. Patients in each group were further divided into subgroup A and B with or without the pain in heart front area, respectively, accompanied by ST-T change in ECG. Comparative analysis of CAG and ECG changes was done between different age groups, and between subgroup A and B. The history of pain in heart front area, serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), platelet count (PLT), and fibrinogen (Fg) were also analyzed for clinical diagnosis. Results In the non-elderly, positive CAG was 88.8% in subgroup A while 56.3% in group B ( P0.05). TC, LDL-C, and Fg were significantly higher in subgroup A than in subgroup B for the elderly group. But in non-elderly, TC, TG, LDL-C, and Fg in subgroup A were significantly higher than those in subgroup B(all P0.05). The history of pain in heart front area was longer in the elderly, and also in this age group, more patients showed multivessel involvement. Conclusions ST-T change of ECG accompanied by classical pain in heart front area is more valuable than single ST-T change in the diagnosis of coronary heart disease, especially among non-elderly patients. ST-T change could not be used simply as a tool to diagnose coronary heart disease. The diagnosis should be made generally considering the typical symptom of the pain in heart front area, clinical history, TC, TG, LDL-C, and Fg. CAG could increase the positive diagnostic rate of coronary heart disease and decrease the rate of misdiagnosis as well.