Title: Lesion characteristics of coronary artery in hypertensives with coronary heart disease
Abstract: Objective To investigate lesion characteristics of coronary artery in hypertensives with coronary heart disease(CHD)and the prognostic evaluation of percutaneous coronary intervention(PCI),and to analyze the correlation between risk factors,such as hypertension,and the complexity of coronary artery disease.Methods From January 2010to June 2010,a total of 462patients from Tianjin Chest Hospital with one or more coronary artery stenosis≥50%,diagnosed by coronary angiography,were enrolled and divided into two groups according to whether they had hypertension:CHD with hypertension group(n=306)and CHD alone group(n=156).Their lesion features of coronary artery were observed,and the SYNTAX integrals were calculated.Major adverse cardiac and cerebrovascular events(MACCE)occurred two years after the operation of the two groups were analyzed,and the diabetes mellitus subgroup was analyzed according to whether the patients were combined with diabetes.Results Compared with that of CHD alone group,the mean SYNTAX integral of CHD with hypertension group was significantly higher[(17.53±9.72)vs(15.21±10.92),P0.05].In the CHD with hypertension group,the complex lesion(58.3% vs 35.0%),calcification lesion,diffuse and long lesion(22.5% vs 10.0%,40.8% vs 28.3%)of target coronary artery lesions,average coronary stenting number[(1.90±0.93)vs(1.66±0.91)]and total rate of MACCE(17.4% vs 6.7%)of patients with PCI were all greater than those in the CHD alone group(all P0.05).In CHD with hypertension group,compared with those of non-diabetes mellitus subgroup,the mean SYNTAX integral,the rate of triple vessel disease,the rates of complex lesion,long diffuse lesion and revascularization,total incidence of MACCE,and readmission rate of diabetes mellitus subgroup were significantly higher(all P0.05).In CHD alone group,compared with those of non-diabetes mellitus subgroup,the mean SYNTAX integral and the triple vessel lesion rate,the rates of complex lesion and long diffuse lesion of the patients with PCI were significantly higher(P0.05),while the single vessel lesion rate was lower(P0.05)in diabetes mellitus subgroup.KaplanMeier survival curves showed no statistically significant difference in the survival rate without events between the two groups(χ2=1.15,P0.05).Logistic regression analysis presented that aging(OR4.107,95% CI 2.2787.405),male(OR2.355,95% CI 1.328-4.174),hypertension(OR2.392,95% CI 1.305-4.384),diabetes mellitus(OR2.446,95% CI1.389-4.308),hypercholesterol(OR2.497,95% CI1.428-4.365),and myocardial infarction history(OR3.333,95% CI 1.382-8.042)were positively correlated with SYNTAX integral(all P0.05).Conclusions The coronary artery lesion characteristics of hypertensive patients with CHD is diffuse and complex with poor prognosis.Hypertension,aging,male,diabetes,hypercholesterol and myocardial infarction history are significant independent predicting factors for the complexity of coronary artery disease.
Publication Year: 2013
Publication Date: 2013-01-01
Language: en
Type: article
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