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To compare the clinical characteristics, risk factors and prognosis of young patients (≤45) with coronary heart disease from 2010 to 2014, and to provide evidence for the second prevention of young patients with coronary heart disease.
According to the inclusion and exclusion criteria, from Jan 1, 2010 to Dec 31, 2014, in the cardiac department of General Hospital of Chinese PLA Hospital, 5288 patients (≤45) were diagnosed as coronary heart disease (CHD) by coronary angiography. From 2010 to 2014, the trends of clinical conditions were compared for 5 years, including onset age, body mass index, heart rate, blood pressure, smoking, drinking, hypertension, diabetes, hyperlipidemia and clinical medication, laboratory examination, cardiac ultrasound, coronary artery lesions and prognosis for one year.
From 2010 to 2014, the incidence of young coronary heart disease increased, especial the young men (91.2%∼94.2%), the stable type angina pectoris increased from 46.9% to 57% and ST segment elevation myocardial infarction increased from 4.4% to 11.9% the non-ST segment elevation myocardial infarction decreased from 38.7% to 28.7% (P<0.05). There is no significant change in the blood pressure, the heart rate is still high (≥72bmp, P<0.05) and body mass index show rising trend (from 27.9±3.1 to 27.6±3.4, P>0.05), hypertension increased from 40.7% to 47.5%, diabetes from 20.3% to 26.1%, hyperlipidemia from 27.3% to 35.7%, while the smoking (61.8%∼57.4%) and drinking (31.1%∼25.0%) showed a downward trend (P < 0.05). Total cholesterol (from 4.54±1.26 to 4.35±1.26), glycerin three fat (from 3.12±6.26 to 2.49±6.83) showed a downward trend (P<0.05), LDL cholesterol showed a downward trend without statistical difference (P>0.05). Single vessel disease is dominant in young patients, left anterior descending, right coronary artery and circumflex artery in turn. Left main lesion was slightly declined. According to the ACC/AHA classification, type A decreased and type C increased (P < 0.05). Aspirin, clopidogrel, ticagrelor, statins and beta blockers increased overall (P<0.05). Mortality in Hospitalization decreased significantly (P<0.05), but there was no significant improvement in the incidence of cardiac death and MACE in 1 year follow-up (P>0.05).
In the past 5 years, the overall incidence of young patients (≤45) with coronary heart disease increased, second prevention for coronary heart disease, including risk factors, as well as medical treatment still need to be improved.