Risk factors for heart failure in patients with coronary atherosclerotic heart disease
10.7683/xxyxyxb.2024.06.011
- VernacularTitle:冠状动脉粥样硬化性心脏病患者心力衰竭危险因素分析
- Author:
Qili YU
1
;
Xue GE
;
Li LIU
Author Information
1. 秦皇岛市第一医院心血管内科,河北 秦皇岛 066000
- Keywords:
coronary atherosclerotic heart disease;
heart failure;
blood pressure;
risk factors
- From:
Journal of Xinxiang Medical College
2024;41(6):560-565
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for heart failure in patients with coronary atherosclerotic heart disease and to analyze the influence of different blood pressure levels on the risk of heart failure.Methods A total of 826 coronary atherosclerotic heart disease patients admitted to the Department of Cardiovascular Medicine of First Hospital of Qinhuangdao from October 2018 to October 2020 were selected as the research subjects.The patients were divided into the heart failure group(n=27)and the non-heart failure group(n=799)based on whether heart failure occurred.The clinical data of patients in the two groups were collected,and the risk factors for heart failure in patients with coronary atherosclerotic heart disease were analyzed by using the univariate and multivariate logistic regression.According to the history of hypertension,the patients were divided into the hypertension history group(n=522)and the normal blood pressure group(n=304),and according to the blood pressure levels,the patients were further divided into the normal blood pressure group(n=304),grade 1 hypertension group(n=102),grade 2 hypertension group(n=254)and grade 3 hypertension group(n=166).The cumulative incidence of heart failure of patients was compared among all groups,and the impact of hypertension history and blood pressure levels on the occurrence of heart failure in patients with coronary atherosclerotic heart disease was analyzed by using the multivariate Cox proportional hazards regression model.Results Univariate analysis showed that there were statistically significant differences in the proportion of advanced age,history of hypertension,history of smoking,coronary artery disease,hemoglobin level,proportion of left atrial enlargement,and proportion of left ventricular hypertrophy between the heart failure group and the non-heart failure group(P＜0.05);and there was no significant difference in gender,history of hyperlipidemia,body mass index,history of diabetes,albumin level,and serum creatinine level between the two groups(P＞0.05).Multivariate logistic regression analysis showed that the history of hypertension,advanced age,multivessel coronary artery disease(≥2 vessels),and left ventricular hypertrophy were risk factors for heart failure in patients with coronary atherosclerotic heart disease(P＜0.05).The cumulative incidence of heart failure in the hypertension history group and the normal blood pressure group was 3.63％(19/522)and 2.63％(8/304),respectively;and the cumulative incidence of heart failure in the hypertension history group was significantly higher than that in the normal blood pressure group(x2=6.792,P＜0.05).The cumulative incidence of heart failure in the normal blood pressure group,grade 1 hypertension group,grade 2 hypertension group,and grade 3 hypertension group was 2.63％(8/304),2.94％(3/102),3.54％(9/254),and 4.22％(7/166),respectively,showing an increasing trend,and there was a significant difference between each group(P＜0.05).In the Cox proportional hazards model,model 1(unadjusted for confounding factors),model 2(adjusted for age factors),and model 3(adjusted for confounding factors such as the history of hypertension,history of smoking,coronary artery distase,hemoglobin level,left atrial enlargement,and left ventricular hypertrophy on the basis of model 2)all showed that the history of hypertension was the risk factor for heart failure in patients with coronary atherosclerotic heart disease,and the higher the blood pressure level,the higher the risk of developing heart failure(P＜0.05).Conclusion The history of hypertension,advanced age,multi vessel coronary artery disease(≥2 vessels),and left ventricular hypertrophy are risk factors for heart failure in patients with coronary atherosclerotic heart disease,among which the history of hypertension has the greatest influence,and the probability of developing heart failure increases as the blood pressure grade increases.
