Zhongguo quanke yixue (Oct 2024)
Comparative Study on Clinical Characteristics of Young and Elderly Patients with Slow Coronary Flow
Abstract
Background The phenomenon of coronary slow flow (CSF) is characterized by recurrent angina pectoris, which may lead to acute myocardial infarction, fatal arrhythmia and sudden cardiac death, and reduce the quality of life of patients. With the improvement of the safety, feasibility and reliability of coronary angiography (CAG), the detection rate of CSF increased gradually. However, there are few studies on the mechanism of early-onset CSF and clinical characteristics of young patients with CSF. Objective To explore the clinical characteristics in young patients with CSF and compare them with the elderly patients in order to provide its pathogenesis. Methods Continuity analysis from January 2017 to January 2019, 86 young patients (18 years ≤ age <45 years) diagnosed with CSF by CAG in the Department of Cardiology at the 305th Hospital of the People's Liberation Army of China were selected as young group, and 88 CSF patients ≥65 years old during the same period were randomly selected as elderly group. Collect and organize clinical data of two groups of patients, including medical history, diagnosis, laboratory tests, and CAG results, for comparative analysis. Results The results showed that the young group had lower average age、hypertension ratio and diabetes ratio than those in elderly group, while the male ratio and BMI were higher than those in elderly group (P<0.05). The number of coronary vascular branches involved in CSF in young group was mainly single branch (58.1%), while in elderly group, the number of vascular branches involved in CSF was mainly three (45.5%) ; There is a statistically significant difference in the distribution of blood vessel branches involved in CSF between two groups of patients (χ2=29.521, P<0.001). The total number of blood vessels affected by CSF in young group was 137, while in elderly group, the total number of blood vessels affected by CSF was 199; There is no statistically significant difference in the distribution of blood vessels involved in CSF between two groups of patients (χ2=1.366, P=0.644). The levels of triglycerides (TG), blood uric acid (SUA), high-sensitivity C-reactive protein (hs-CRP), and endothelin-1 (ET-1) in young group were higher than those in elderly group, while the levels of nitric oxide (NO) were lower than those in elderly group (P<0.05) . Conclusion Compared with the elderly patients with CSF, the young patients with CSF are more male and higher BMI, and the number of vessels involved in CSF is less. The levels of TG, SUA, hs-CRP, and ET-1 are higher, while the proportion of hypertension and diabetes is lower. Metabolic abnormalities, inflammatory reactions, and impaired endothelial function are more closely related to the onset of CSF in young adults.
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