Clinical characteristics and risk factors of coronary atherosclerotic stenosis in proximal myocardium

MA He; ZHANG Jia-xi; GAO Wen

doi:10.3969/j.issn.1674-4055.2017.06.32

Abstract：Objective To investigate the relationship between the degree of myocardial stenosis and the incidence of cardiovascular events, the incidence of proximal stenosis, and the risk factors of proximal myocardial stenosis.Methods 244 patients with myocardial bridge were enrolled from October 2011 to December 2014. Among them, 86 patients were female, mean age (58.52±6.95) years old; 158 patients were male, mean age (54.22±10.34) years old. Patients were divided into class I (systolic stenosis <50%), class Ⅱ (50 to 75% systolic stenosis), class III (systolic stenosis ≥75%) according to the degree of systolic stenosis of the myocardial bridge (Noble classification). The age, gender, incidence of proximal myocardial stenosis, angina pectoris, the incidence of acute myocardial infarction, and the risk factors of proximal myocardial stenosis were compared.Results There was no significant difference in gender and age between class Ⅱ-Ⅲ group and class I group (P>0.05). The stenosis rate of myocardial bridge in class Ⅱ-Ⅲ group was significantly higher than that in class I group (56.4%vs. 28.3%,P<0.05). The incidence of cardiovascular events (53.8%, 33.3%) in patients with angina pectoris and acute myocardial infarction was higher than that in class I group (12.7%, 6.0%,P<0.05). Logistic regression analysis result showed that gender (OR=1.78,P=0.010), hypertension (OR=1.75,P=0.013), Noble grade (OR=2.31,P=0.016) were the risk factors of proximal myocardial stenosis in patients with myocardial bridge.Conclusion The greater the degree of myocardial bridge compression, the higher the incidence of cardiovascular events (angina pectoris, acute myocardial infarction), the higher the incidence of proximal myocardial stenosis. Gender, Hypertension, Noble classification is a risk factor for myocardial bridge with proximal stenosis.