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[Clinical evaluation of risk factors for coronary heart disease]
Ya-ping Jin1, Guang-ming Qin, Song-zhao Zhang
1The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
Insights
This study found that hyperlipidemia history predicts coronary heart disease (CHD). High-density lipoprotein cholesterol ratio and lipoprotein(a) levels are strong predictors for high blood lipids, while high-sensitivity C-reactive protein indicates coronary inflammation.
Area of Science:
- Cardiology
- Biochemistry
- Public Health
Context:
- Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
- Identifying reliable risk factors and predictors is crucial for early detection and prevention of CHD.
- Coronary angiography is a standard diagnostic tool for assessing coronary artery lesions.
Purpose:
- To investigate the association between established coronary heart disease (CHD) risk factors and the presence and severity of coronary artery lesions.
- To evaluate the predictive value of various biomarkers and clinical factors in identifying individuals with coronary artery disease.
Summary:
- A study of 341 patients undergoing coronary angiography revealed significant differences in age, diabetes, family history, smoking, HDL-C, LDL-C, TC/HDL-C, Lp(a), fibrinogen, and hs-CRP between patients with and without coronary lesions.
- Severity of coronary artery lesions correlated significantly with hs-CRP, Lp(a), TC/HDL-C, fibrinogen, hyperlipidemia, TC, LDL-C, and TG.
- ROC curve analysis indicated strong predictive values for hs-CRP, TC/HDL-C, and Lp(a) in identifying coronary artery disease.
Impact:
- Past hyperlipidemia history emerged as a significant predictor for CHD occurrence.
- The ratio of total cholesterol to HDL-C (TC/HDL-C) and lipoprotein(a) [Lp(a)] levels show strong potential as screening tools for dyslipidemia.
- High-sensitivity C-reactive protein (hs-CRP) demonstrates excellent predictive value for active coronary inflammatory processes, aiding in risk stratification.
Objective:
To explore the relationship between risk factors for coronary heart disease (CHD) and coronary artery lesions.
Method:
Potential risk factors were studied in 341 patients underwent coronary angiography.
Results:
(1) Coronary angiography showed coronary artery lesions in 214 patients (lesion group), and no lesion in 127 patients (non-lesion group). There was significant difference in age, past history of diabetes, family history of CHD, smoking history, high-density lipoprotein cholesterol (HDL-C), lower-density lipoprotein cholesterol (LDL-C), ratio of total cholesterol to HDL-C (TC/HDL-C), lipoprotein(a) [Lp(a)], fibrinogen (Fbg) and high-sensitivity C-reactive protein (hs-CRP) between two groups (P < 0.05). (2) There was significant correlation between severity of coronary artery lesions and hs-CRP, Lp(a), TC/HDL-C, Fbg, hyperlipidemia, TC, LDL-C and TG (with coefficients of correlation of 0.338, 0.250, 0.241, 0.207, 0.167, 0.147, 0.140 and 0.139; respectively, P < 0.05). (3) Analysis of receiver operating characteristics (ROC) curve for patients with coronary angiography and risk factors for CHD showed that the areas under ROC curve were 0.810, 0.669, 0.626, 0.625, 0.619 and 0.618 for hs-CRP, TC/HDL-C, Lp(a), Fbg, LDL-C and past history of hyperlipidemia, respectively.
Conclusions:
Past history of hyperlipidemia was a predictor for occurrence of CHD. Ratio of TC/HDL-C and blood level of Lp(a) could be used as predictors in screening for high blood lipid, which were much stronger than others. It is suggested that hs-CRP had an excellent predictive value in current coronary inflammatory lesions.