Relation of atherosclerosis risk factors with the number of involved coronary arteries in angiography

Abstract

Introduction: Coronary artery disease is the first leading cause of mortality in modern societies and formed the first cause of health expenditure. Male gender, diabetes mellitus, hypertension, hyperlipidaemia, family history of ischemic heart disease, personal history of ischemic heart disease, age, height, weight and smoking are the main risk factors for atherosclerosis and coronary artery diseases. Despite the abundant existing information about relation of these risk factors and atherosclerosis, there are different results regarding the relationship between these risk factors and the number of involved coronary arteries. The aim of this study is to determine the relation of these risk factors of coronary atherosclerosis with the number of involved coronary artery in angiography.

Material and Methods: In this cross-sectional study, a total of 300 patients during 8 months in ShahidMadani heart hospital were carried out as convenience sampling. Data was collected by questionnaire including age, sex, weight, height and body mass index, diabetes mellitus, hypertension, family history of coronary heart disease, smoking, drug addiction, occupation, place of residence and education were studied. Number of coronary arteries stenosis revealed by angiography. Data were analysed by software 17SPSS, Chi-square test, T test and ANOVA.

Results: A total of 300 patients with a mean age of 63.3±11.2 year were enrolled. Collected data showed that 71% were male, 33.3% smokers, 57.3% hypertensive, 30% diabetic, 27.7% with hyperlipidaemia, 70.34% obese and 14% with a family history of heart disease. Frequency of one, two and three vessel involvement was respectively 30%, 32% and 38%. There was a statistically significant relationship between ages, history of ischemic heart disease with the number of involved coronary artery.  But there was no significant relationship with gender, body mass index, smoking and drug addiction, hypertension, family history of heart disease, location and education level with number of involved coronary artery.

Conclusions: Our study showed that despite the known role of conventional risk factors with the incidence and growth rate of atherosclerosis, but there is no direct correlation with some of these risk factors and the number of involved coronary arteries in coronary angiography

Keywords

• Coronary artery disease; Risk factors; Stenosis

Kaynakça

1. ZandParsa AF, Ziai H &Fallahi B. The relationship between cardiovascular risk factors and the siteand extent of coronary artery stenosis during angiography, School of Medicine of Tehran Medical Sceiences Journal 2010; 68(3): 182-7.
2. Lukkarinen, H., Hentinen, M. Treatments of coronary artery disease improve quality of life in the long term, Nurs Res 2006; 55: 26-33.
3. Behjati J.Principles of Internal MedicineSicily2010 (Endocrinology and Metabolism). The ideasublimePublications, Tehran, first edition 2011; 20 (Persian).
4. Maassoumi M. The effect ofcardiac rehabilitationonbody compositionand fat distributionin patients withcoronary artery disease, Hakim Research Journal2005; 8(3):17-34(Persian).
5. Goldman L, Schafer A. Goldmans Cecil Medicine, 24st ed, Philadelphia, United States Of American. 2011; 256-409.
6. KariminejadA.Investigate thegeneticpolymorphism ofACEas a cause ofcardiovascular diseasein thepopulation, genetic2010;8(1): p1(Persian).
7. Sadegi M. Prevalence ofcoronary artery diseasein centralIranAriaJournal 2006; 6(35):70-74. (Persian).
8. ImanipourM. 1385, Associationtocoronaryartery bypass graftextubation time Patients, Faculty ofNursing and Midwifery,Tehran 2006 ;12(1):5-16 (Persian).

9. Nixon JM. The AHA Clinical Cardiac Consult, 3st ed, Williams&Willkins, United States of American 2011;4-5.
10. Bonow L. Braunwald`s Heart disease, 9st ed, Philadelphia, United States of American 2011;1727-1758
11. Gazianojm, LibbyP, Bonow Ro. Globa burden of cardiovascular disease.Braunwalds Heart Deases 2005; 7:423-55.
12. Falk E, Shah PK, Fuster V. Atherothrombosis and thrombosisprone plaques. In: Fuster V, Alexander RW, O'Rourke RA, editors. Hurst's The Heart. 11th ed. New York: McGraw-Hill,p. 2004; 1123-34.
13. Scott MG, Gary JB, Michael HC. Primary prevention of coronary heart disease: Guidance from Framingham. Circulation 199; 97:1876-87.
14. Grundy SM, Bilheimer D, Blackburn H. Rationale of the diet-heart statement of the American heart association. Circulation 1982 ;65(4):839-54..
15. Kartz M. Dietary cholesterol, atherosclerosis and coronary heart disease.HandbExp Pharmacol2005; 170:195- 213.
16. American Heart Association. 1998. Heart and stroke statistical update heart and stroke statistical update. Texas: American Heart Association.
17. Fellows JL, Trosclair A. Annual smoking-attributable mortality, years of potential life lost and economic costs:United States 1995-1999, MMWR Morb Mort Wkly, 2002 ;51(14):300-3.
18. Asgary S, Sarrafzadegan N, Naderi GA, Rozbehani R. Effect of opium addiction on new and traditional cardiovascular risk factors: do duration of addiction and route of administration matter. Lipids Health Dis 2008; 7: 42.
19. Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison's Principles of Internal medicine, New York: McGraw-Hill Medical Publishing Division, 17th ed, vol 2. 2008; 1365:158.
20. Pourmand K, Sadeghi M, Sanei H, Akrami F, Talaei M. Which major atherosclerosis' risk factor represents the extent of coronary artery disease?, J Isfahan Med Sch 2007; 25: 61-71.
21. Molstad P. Coronary heart disease in diabetics: prognostic implications and results of interventions. ScandCardiovasc J 2007; 41: 357-362.
22. Jankowski P, Kawecka-Jaszcz K, Bilo G, PajakA. Determinants of poor hypertension management in patients with ischaemic heart disease. Blood Press 2005; 14: 284-292.
23. Saedi M, AkhavaTabib A, Jokar MH, Yazdani A Prevalence of cardiovascular risk factors in male individuals with hypertriglecamic waist phenotype. Med J MashadUniv Med Scince 2007; 50: 259-268.
24. Murray CJL, Lopez AD.. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet 1997; 349:1498-1504..
25. Kreatsoulas C, Natarajan MK, Khatun R, Velianou JL, Anand SS. Identifying women with severe angiographic coronary disease. J Intern Med 2010;268: 66-74.
26. Elkind MS, Sciacca R, Boden-Albala B, Homma S, Di Tullio MR. Leukocyte count is associated with aortic arch plaque thickness. Stroke 2002; 33(11): 2587-92.
27. Zeltser D, Rogowski O, Fusman R, Rotstein R, Rubinstein A, Koffler M, et al. The multiplicity of atherosclerotic risk factors corresponds to the appearance of increased leukocyte count in the peripheral blood¸relevance to the pathogenesis of the disease¸JCardiovasc Risk 2001; 8 (6): 379 82.
28. Humphries KH, Pu A, Gao M, Carere RG &Pilote L. Angina with “normal” coronary arteries: Sex differences in outcomes. American Heart Journal 2008; 155(2): 375-81.
29. Masoomi M &Nasri HR. Relationship between coronary risk factors and the number of involved vessels in coronary angiography. Journal of Hormozgan University of Medical Sciences 2006;10(1): 29-34
30. Bigi R, Cortigiani L, Colombo P, Desideri A, Bax JJ,Parodi O. Prognostic and clinical correlates of angiographically diffuse non-obstructive coronary lesions. Heart 2003; 89: 1009-1013.
31. Darabian S, Abbasi A. The correlation of ischemic risk factors with left main tract disease.Feyz2007 ; 11: 31-35.
32. Veeranna V, PradhanJ, Niraj A, Fakhry H, Afonso L. Traditional cardiovascular risk factors and severity of angiographic coronary artery disease in the elderly. prevcardiol 2010;13: 135- 140.
33. Hochner-Celnikier D, Manor O, Gotzman O, Lotan H, Chajek-Shaul T. Gender gap in coronary arteryndisease: comparison of the extent, severity and risk factors in men and women aged 45-65 years. Cardiology2002 ;97(1):18-23.
34. Kreatsoulas C, Natarajan MK, Khatun R, Velianou JL &Anand SS. Identifying women with severe angiographic coronary disease. Journal of Internal Medicine 2010;268(1): 66–74.
35. HosseiniA, Abdullah A, Behnam pour N, Salehi A. peace be upon him, calledpornography, Relationship betweencardiovascular risk factorsandvasculardiseasebased on theresults ofangiography, ParamedicalFaculty ofTehranUniversity of Medical Sciences(Payavardhealth)2011;6(5):391-383.
36. Niraj A, Pradahan J, Fakhry H, Veeranna V &Afonso L. Severity of Coronary Artery Disease in Obese Patients Undergoing Coronary Angiography: Obesity Paradox Revisited. ClinCardiol 2007; 30(8): 391–6
37. Auer J, Weber T, Berent R, Lassnig E, Maurer E, Lamm G, et al. Obesity, body fat and coronary atherosclerosis. International Journal of Cardiology 2005; 98(2): 227–35.
38. Alam SamimiM, ImadMAzamiM, NajafiJ,Jamshidian M, Investigatethe relationship betweenserum ferritin levelwithcoronary artery disease, Kowsar Medical Journal 2008;13(3):245-252.
39. Sukhija R, Aronow WS, Nayak D, Ahn C, Weiss MB. Increased fasting plasma insulin concentrations are associated with the severity of angiographic coronary artery disease. Angiology 2005; 56 (3):249-51.
40. Hong MK, Romm PA, Reagan K, Green CE, Rackley CE. Usefulness of the total cholesterol to high-density lipoprotein cholesterol ratio in predicting angiographic coronary artery disease in women.Am J Cardiol 1991; 68(17):1646-50.
41. Sposito AC, Mansur AP, Maranhão RC, Martinez TR, Aldrighi JM, Ramires JA. Triglyceride and lipoprotein (a) are markers of coronary artery disease severity among postmenopausal women.Maturitas 2001; 39(3):203-8.
42. Aygul N, Ozdemir K, Abaci A, Aygul MU, Duzenli MA, Yazici HU, et al. Comparison of Traditional Risk Factors, Angiographic Findings, and In-Hospital Mortality between Smoking and Nonsmoking Turkish Men and Women With Acute Myocardial Infarction. ClinCardiol 2010 ; 33(6): 49–54.
43. Sadeghi A, Nizal S, NaderiGh.A, RozbehaniR..Effect of opium addiction on new and traditional cardiovascular risk factors: do duration of addiction and route of administration matter? Lipids in Health and Disease 2008; 7(42):1-5.
44. GuoYh. study of the relationship between cardio vascular riskfactors and severity of the coronary artery disease, patient underwent coronary angiography2005;5:415-518
45. Gibbons RJ. ACC/AHA 2002 Guideline Update for Exercise Testin. Report of the American College of Cardiology/American Heart Association
46. Libby P. Current concepts of the pathogenesis of the acute coronary syndromes. Circulation 2001;104(3):365.