Study on Relationship between Pulse Pressure, Pulse Pressure Index and Severity of Coronary Heart Disease
|School||Tianjin Medical University|
|Keywords||Coronary heart disease Coronary artery angiography Coronary artery score Pulse pressure Pulse pressure index|
Objective: To study the correlation between the pulse pressure(PP),the level of pulse pressure index(PPI) and the severity of coronary artery disease, searching for the value of PP and PPI during the development of coronary artery disease(CAD), so that we can offer useful data and clue to the prevention and treatment of coronary heart disease.Methods: Using the retrospective case analysis, collecting 280 patiens admitted in cardiology department from August, 2004 to February, 2006, who underwent coronary artery angiography(CAG). There were 173 male patients and 107 female ones, aged from 44years old to 78 years old(61.11±10.10). All of them were measured with brachial systolic blood pressure, diastolic blood pressure, pulse pressure and pulse pressure index. At the same time,patients preprandial was examed by routine assay,the essential hypertension(EH) history,diabetes history and smoking history were recorded.The patients were divided into CAD group and non-CAD group by the result of CAG.Coronary artery score( Gensini score) was calculated for assessing the severity of coronary artery stenosis. According to the number of suffered coronary artery,patients were divided into one-vessel pathological,two-vessel pathological and three-vessel pathological;patients were also divided into two groups by more or less than 60 years old, and the value of PP higher or lower than 65mmHg, the score of PPI more or less than 0.5. Results: With the increasing of PP and PPI, the prevalence of CAD was increasing. With the patients getting older, the cases of two- vessel pathological and three-vessel pathological were obviously increasing. In the group of PP=65mmHg, the percentage of CAD and three-vessel pathological is much higher.(86.6%vs74.2%, 35.1%vsl5.4%, P<0.001), the score of coronary artery stenosis is much higher(P < 0.001). In the group of PPI=0.5, the percentage of CAD and two- vessel pathological and three- vessel pathological is much higher (92.1%vs71.2%, 38.1%vs29.3%, 36.0%vsl5.7%, P< 0.001) .We chose Gensini score as the dependent variable, chose every dangerous factors as the independent variables, using the Bivariate correlations to analyze. The results shown that the degree of coronary artery stenosis had positive correlation with the EH history, diabetes history and smoking history (r=0.196~0.363,P P<0.01), had positive correlation with age, TC, apoB, FBS, SBP, PP and PPI (r=0.161~0.379,P<0.05) , had negative correlation with HDL-C,apoA-I and DBP (r=-0.167~-0.221,P<0.05) . After the multiple stepwise regression, we got that PPI, age and smoking were the best predictor for the severity of coronary artery stenosis ,without the influence of EH history, diabetes history, blood lipid, FBS and SBP. Conclusion:l.PP and PPI were the most convenient parameter reflacting the elasticity of large artery, had closely correlation with the severity of coronary artery stenosis. PPI had much more advantages than PP on predicting the risk of cardiovascular. 2.PPI, age and smoking were the independent parameter of the severity of coronary artery stenosis.3. The severity of coronary artery stenosis had positive correlation with PPI, PP, SBP, age, EH history, diabetes history, smoking history, TC, apoB and FBSrespectively;had negative correlation with HDL-C, apoA-I and DBP, and had nocorrelation with gender, TG, LDL-C, UA, BMI, INS and MAP.4. The increasing of PP had something to do with age, the history of HBP, smoking,while had nothing to do with gender and blood lipid.