Qian Jie

e0284 Intravascular ultrasound (IVUS) characteristics of premature coronary heart disease (CHD) patients with different risk factors

Objectives To observe lesion characteristics of premature coronary heart disease (CHD) patients with different risk factors by intravascular ultrasound (IVUS). Methods Among 114 premature CHD patients examined by IVUS, quantitative method and qualitative method were adopted to analyse characteristics of coronary artery plaques, and to observe the proportion of different plaques, cross-sectional areas (CSA) surrounded by external elastic membrane, lumen CSA, plaque burden, lumen area stenosis rate and remodelling index of patients with different risk factors. Results Among the CHD patients with traditional risk factors, there is no statistical difference except in lesion extent and minimum lumen diameter among those CHD patients with hypertension. The lesions are serious and higher ratio of lipid core to plaque among those CHD patients with diabetes. More soft plaques and mixed plaques are observed among those CHD patients with hyperlipidaemia. Lesion length and the ratio of lipid core to plaque were significant difference between premature CHD patients with hyperlipidaemia and control groups. There is no difference on lesion characteristics detected by IVUS between patients with and without family history of CHD. There are more soft plaques and mixed plaques in the premature CHD patients in current smoking group (the p value were <0.05). The lesions were more serious in current smoking patients than those without smoking patients. There were more ruptured plaques in diabetes group. Positive remodelling is a common phenomenon in diabetes group, while more negative remodelling were observed in other groups. Conclusions The ratio of lipid core to plaque tends to be higher in group with risk factors than that in group without risk factors. More ruptured plaques were observed among those CHD patients with diabetes. Therefore, these risk factors should be strictly controlled in primary prevention of CHD.

e0354 Angiographic characteristics of premature coronary heart disease—analyses of single center

Background There are no large-sample published reports prospectively or consecutively assessing the angiographic characteristics of premature coronary heart disease in China. Objectives The present study was carried out to collect and analyse the clinical and angiographic characteristics in a single center. Methods From April 2004 to April 2008, based on the screening condition of male <55 years and female (<65 years), we selected premature coronary heart disease from a dedicated database of coronary angioplasty registry of the Center for Diagnosis & Treatment of Coronary Artery Disease, Fuwai Hospital. They had been subjected to coronary angiogram due to the angina pectoris or asymptomatic myocardial ischaemia in coronary heart disease. Results 4478 consecutive patients (3056 males, 1422 females), average age was (49.9±7.0) years, were defined as coronary heart disease according to clinical manifestation and coronary angiogram. Patients with unstable angina pectoris (UAP), stable angina pectoris (SAP) and without angina pectoris were 2400, 1534 and 544, respectively. The proportion of coronary heart disease, hypertension, hyperlipidaemia, diabetic mellitus (DM), smoking history, prior myocardial infarction (MI), prior percutaneous intervention (PCI), coronary artery bypass graft and history of cerebrovascular diseases were 6.7%, 53.0%, 35.3%, 20.8%, 90.3%, 43.3%, 16.6%, 1.5%, 1.1%, respectively. The ratio of eccentric lesions, concentric lesions, chronic total occlusion lesions (CTO) and calcified lesions were 93.7%, 23% and 42.8%, respectively. Comparison between UAP and SAP, there was more MI, PCI, complex lesions (B2+C), eccentric lesions and calcium lesions among 3934 patients. There were more MI, PCI, DM, hyperlipidaemia, hypertension, cerebrovascular diseases, smoking, eccentric lesions complex lesions, angulated lesions and calcified lesions in male than that in female (all p<0.05). Conclusions The ratio of sex and clinical findings are different in Chinese Premature coronary heart patients. There were more MI, PCI, complex lesions, eccentric lesions and calcified lesions in UAP group, comparison between sexes, there were higher incidences of hypertension, hyperlipidaemia, cerebrovascular disease and smoking history in male.