ISSN: 1859 - 2872
Association between cardiovascular risk factors and coronary artery morphology, severity of lesions on multi-slice computed tomography in patients with stable angina
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Abstract
Objective: To determine the prevalence of traditional cardiovascular risk factors (CVRFs) and their association with the severity of coronary artery morphology and the severity of lesions in patients with stable angina (SA). Subject and method: A cross-sectional study was conducted on 270 patients (mean age 64.7 ± 7.9 years, 70% male) diagnosed with SA, who underwent coronary computed tomography (CT) angiography to assess coronary artery stenosis or occlusion. Coronary artery disease was defined as ≥ 50% diameter stenosis in at least one major epicardial coronary artery branch. Coronary morphology and severity of of lesions was assessed using the Gensini score. Result: At least one CVRF was observed in 98.5% of patients, with 68.9% having 2-3 risk factors, 20% having 4-5 risk factors. The most common risk factor was dyslipidemia (88.5%), followed by hypertension (85.6%), smoking (43.3%), and diabetes (41.1%). There was no statistically significant difference in the prevalence of risk factors between genders, except for smoking, which was significantly higher in males (60.8% vs. 2.5% in females, p<0.001). The proportion of patients with 2-3 vessel disease was 32.6%. The median Gensini score was 44.5 points (interquartile range [IQR]: 27-64 points). There was a significant association between the number of CVRFs and the morphology, severity of CAD as measured by the Gensini score: The median Gensini scores for groups with 0-1, 2-3, and 4-5 risk factors were 32 points (IQR: 25.7-48.2), 43.5 points (IQR: 26-64), and 52.5 points (IQR: 31-78.5), respectively, p=0.017. Logistic regression analysis revealed that a risk factor was associated with high Gensini score with an odds ratio of 1.43 (95% confidence interval 1.06-1.95, p=0.02). Conclusion: Patients with SA and coronary artery lesions typically had at least one CVRF, and the number of risk factors was associated with the morphology and severity of coronary lesions on CT angiography.
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References
2. World Health Organization (2018) Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2016. Geneva; 2018. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates.
3. Canto JG, Kiefe CI, Rogers WJ et al (2011) Number of Coronary Heart Disease Risk Factors and Mortality in Patients With First Myocardial Infarction. JAMA 306(19): 2120-2127.
4. Greenland P, Knoll MD, Stamler J et al (2003) Major Risk Factors as Antecedents of Fatal and Nonfatal Coronary Heart Disease Events. JAMA 290(7): 891-897. doi:10.1001/jama.290.7.891.
5. Aksu F, Ahmed S (2024) Gensini Score’s Severity and Its Relationship with Risk Factors for Coronary Artery Disease Among Patients Who Underwent Angiography in Somalia’s Largest PCI Centre. Int J Gen Med 17: 187-192. doi:10.2147/ijgm.s384626.
6. Bộ Y tế (2020) Thực hành chẩn đoán và điều trị bệnh động mạch vành. Ban hành kèm theo Quyết định 5332/QĐ-BYT.
7. Knuuti J, Wijns W, Saraste A et al (2020) 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 41(3): 407-477. doi:10.1093/eurheartj/ehz425.
8. Tamis-Holland JE, Jneid H, Reynolds HR et al (2019) Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association. Circulation. 139(18): E891-E908. doi:10.1161/CIR.0000000000000670.
9. Rampidis GP, Benetos G, Benz DC, Giannopoulos AA, Buechel RR (2019) A guide for Gensini Score calculation. Atherosclerosis 287: 181-183. doi:10.1016/j.atherosclerosis.2019.05.012.
10. Ko DT, Wijeysundera HC, Udell JA et al (2014) Traditional cardiovascular risk factors and the presence of obstructive coronary artery disease in men and women. Can J Cardiol 30(7): 820-826. doi:10.1016/j.cjca.2014.04.032.
11. Park J, Kim HL, Kim MA et al (2021) Traditional Cardiovascular Risk Factors and Obstructive Coronary Disease in Patients with Stable Chest Pain: Gender-specific Analysis. CardioMetabolic Syndr J. 1(1):101. doi:10.51789/cmsj.2021.1.e7.
12. Đỗ Thị Thu Hà (2008) Hội chứng chuyển hóa ở bệnh nhân bệnh động mạch vành. Tạp chí Y học Thành phố Hồ Chí Minh 12(1), tr. 43-49.
13. Jariwala P, Padmavathi A, Patil R, Chawla K, Jadhav K (2020) The prevalence of risk factors and pattern of obstructive coronary artery disease in young Indians (< 45 years) undergoing percutaneous coronary intervention: A gender-based multi-center study. Indian Heart J 74(4): 282-288. doi:10.1016/j.ihj.2022.07.001.
14. Vranic I, Stankovic I, Ignjatovic A et al (2024) Validation of the European Society of Cardiology pretest probability models for obstructive coronary artery disease in high-risk population. Hell J Cardiol doi: 10.1016/j.hjc.2024.05.003.
15. Lopes PM, Albuquerque F, Freitas P, et al (2022) The updated pre-test probability model of the 2019 ESC. Rev Port Cardiol 41(6): 445-452.
16. Bing R, Singh T, Dweck MR et al (2020) Validation of European Society of Cardiology pre-test probabilities for obstructive coronary artery disease in suspected stable angina. Eur Hear J - Qual Care Clin Outcomes 6(4): 293-300. doi:10.1093/ehjqcco/qcaa006.
17. Veeranna V, Pradhan J, Niraj A, Fakhry H, Afonso L (2010) Traditional Cardiovascular Risk Factors and Severity of Angiographic Coronary Artery Disease in the Elderly. Prev Cardiol 13(3): 135-140. doi:10.1111/j.1751-7141.2009.00062.x.
18. Sørgaard M, Linde JJ, Kofoed KF, et al (2015) Diagnostic value of the updated diamond and forrester score to predict coronary artery disease in patients with acute-onset chest pain. Cardiol 133(1): 10-17. doi:10.1159/000438980.
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