Coronary angiography characteristics of coronary artery lesions in 2742 patients of different ages

Abstract

Objective To summarize and analyze the characteristics and differences of coronary angiography (CAG) findings in coronary artery disease patients of various age groups to help make decision-making for clinical diagnosis and treatment. Methods A retrospective analysis was made on 2742 patients who underwent CAG at the Fifth Affiliated Hospital of Kunming Medical University/Hong-He Central Hospital of Southern Yunnan from January 2013 to December 2016. The patients were divided into a youth group [n=126; age, 18-40 years; mean age, (35.10±4.91) years], middle-aged group [n=1774; age, 41-65 years; mean age, (55.00±6.60) years], and old age group [n=842; age, ≥66 years; mean age, (71.68±4.49) years]. The self-developed CAG Epidata database was used to collect basic information and the data for coronary artery lesions, including the lesion characteristics of the left main coronary artery (LM), left anterior descending branch (LAD), left circumflex branch (LCX), and each vessel of the right coronary artery (RCA), TIMI blood flow, placement of stents, and surgery. Gensini score was calculated according to the American Heart Association′s evaluation criteria for coronary stenosis. Results The composition ratios of patients in the young, middle-aged, and elderly groups were 4.6%, 64.7%, and 30.7%, respectively, with middle-aged and elderly patients accounting for the highest proportion (95.4%). The ratios of males (84.1%, 65.8%, 58.7%), age [(35.10±4.91) years, (55.00±6.60) years, (71.68±4.49) years], LM lesions (0.8%, 5.4%, 12.4%), RCA lesions (38.9%, 62.5%, 77.7%), LAD lesions (55.6%, 81.0%, 92.2%), and LCX lesions (23.0%, 52.5%, 71.1%) differed significantly among the three groups (P 0.05). The percentages of patients with grade 3 TIMI blood flow in RCA, LAD, and LCX lesions [RCA: 61.1%, 86.0%, 84.9%; LAD: 54.8%, 75.2%, 82.5%; LCX: 75.4%, 47.9%, 62.6%, grade 0 TIMI blood flow in LAD lesions (15.1%, 7.7%, 7.6%), grade 1 TIMI blood flow in LCX lesions (1.6%, 0.3%, 1.7%), and grade 2 TIMI blood flow in LCX lesions (15.9%, 1.5%, 2.0%) differed significantly among the three groups (P 0.05). Conclusion Coronary lesions are different in different age groups. The incidence of coronary artery lesions increases with age. The ratios of LM, RCA, LAD and LCX coronary lesions as well as the percentages of patients with diffuse lesions, calcification lesions, collateral circulation, and severe lesions differ significantly in different age groups. Gensini score increases with age. Patients of different ages have the highest rate of LAD lesions among different arteries. LCX lesions have the most significant difference in grades 1 and 2 TIMI blood flow. Key words: Different ages; Coronary angiography; Characteristics of coronary lesions; TIMI blood flow grading; Gensini score