2015, Number 2
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Rev Cubana Cardiol Cir Cardiovasc 2015; 21 (2)
Risk factors in patients with angiographically severe coronary artery disease: differences by sex
Castro MAF, Ortega AME, López FLH
Language: Spanish
References: 21
Page: 70-77
PDF size: 647.53 Kb.
ABSTRACT
Introduction: Ischemic heart disease is the leading cause of death worldwide and it is important to establish the influence of risk factors on the severity of it.
Objective: To determine the possible association of classic risk factors with angiographically severe coronary artery disease in both sexes.
Methodologic design: Analytical, cross sectional study with 1000 patients randomly chosen those who underwent coronary angiography at the Institute of Cardiology and Cardiovascular Surgery of Habana in 2012. Demographic variables, cardiovascular risk factors, coronary vessels affected and severity of these were studied.
Chi square test for the quantification of the risk the odds ratio and logistic regression was used was used for the association of the variables.
Results: The predominant age group in both sexes was 60 or more years. 32% of women were diabetic. Left main coronary was affected in 18% of women. 16.3% of the male population had three-vessel disease. Diabetes mellitus and obesity increased the risk of three-vessel disease in women (OR = 3.23 and OR = 4.9 respectively), also increased risk (OR = 1.2; p = 0.005) of developing severe ischemic heart disease (TCI and / or three-vessel disease) in females in univariate analysis and multivariate analysis (OR = 2.061; p = 0.012) by means of logistic regression.
Conclusion: Diabetes mellitus increased the risk of angiographically severe coronary artery disease in women of this series.
REFERENCES
Longo D, Kasper D, Jameson J, Fauci A, Hauser S, Loscalzo J. Harrison's Principles of Internal Medicine. 18 ed. United States of America: McGraw-Hill Professional; 2012.
Daviglus M, Stamler J, Pirzada A, Yan L, Garside D, Liu K. Favorable Cardiovascular Risk Profile in Young Women and Long-term Risk of Cardiovascular and All-Cause Mortality. JAMA. 2004;292:1588-92.
Chobanian A, Bakris G, Black H, Cushman W, Green L, Izzo J, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 report. JAMA.2003;289:2560-72.
Kannel WB,Castelli WP, Gordon T,MCnamara PM. Serum cholesterol, lipoproteins, and the risk of coronary heart dis-ease. The Framingham study.Ann Intern Med.1971;7:1-12.
Hokanso JE, Austin MA. Plasma triglyceride level is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: a meta-analysis of population-based prospective studies. J Cardiovasc Risk.1996;3:213-9.
Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, et al.Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTER-HEART study): case-control study. Lancet. 2004;364:937–52.
Beckman J, Creager M, Libby P. Diabetes and Atherosclero-sis. Epidemiology, Pathophysiology, and Management. JA-MA. 2002;287:2570-81.
Bonow R, Mann D, Zipes D, Libby P. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, Ninth edi-tion. Philadelphia: Elsevier Saunders; 2012.
Howell JD. Coronary Heart Disease and Heart Attacks, 1912–2010. Medical History. 2011;55:307–12.
Berger JS, Elliott L, Gallup D, Roe M, Granger CB, Armstrong PW,et al. Sex differences in mortality following acute coronary syndromes. JAMA. 2009;302:874-82.
Roger V, Go A, Lloyd-Jones D, Adams R, Berry J, Brown T, et al. Heart Disease and Stroke Statistics2011 Update: A Re-port From the American Heart Association. Circula-tion.2011;123:e18-e209.
Dirección nacional de registros médicos y estadísticas de sa-lud. Anuario Estadístico de Salud 2011. La Habana: DNE, MINSAP; 2012.
Gale C, Manda S, Weston C, Birkhead J, Batin P, Hall A. Evaluation of risk scores for risk stratification of acute coro-nary syndromes in the Myocardial Infarction National Audit Project (MINAP) database. Heart. 2009;95:221–7.
Katircibasi M, KoÇum H, Baltali M, Erol T, Tekin A, Yigit F, et al. Effect of female gender on the outcome of coronary artery bypass surgery for left main coronary artery disease. AnadoluKardiyolDerg. 2007;7:134-9.
GehaniAA, El-Menyar A, Elgendy I, Abuzaid A, Ahmed E, Haque S, et al. Clinical Presentation and Cardiovascular Risk Profiles in Patients With Left Main Coronary Artery Disease in a Middle Eastern Country. Angiology. 2012;64:195-9.
Canto JG, Kiefe CI, Rogers WJ, Peterson ED, Frederick PD, French WJ,et al. Number of Coronary Heart Disease Risk Factors and Mortality in PatientsWith First Myocardial In-farction. JAMA. 2011;306:2120-7.
Fuster V. Enfermedad crónica multivaso: ayer, hoy y maña-na. RevEspCardiol. 2008;61:2-9.
Niccoli G, Giubilato S, Di Vito L, Leo A, Cosentino N, Pi-tocco D, et al. Severity of coronary atherosclerosis in patients with a first acute coronary event: a diabetes paradox. Eur-Heart J. 2013;34:729-41.
ESC. Guía de práctica clínica sobre revascularización miocárdica. RevEspCardiol. 2010;63:1485.e1-e76.
Roffi M, AngiolilloD,Kappetein A. Current concepts on co-ronary revascularization in diabetic patients. Eur Heart J. 2011;32:2748–57.
KalyaniRR, Lazo M, Ouyang P, Turkbey E, Chevalier K, Brancati F, et al. Sex Differences in Diabetes and Risk of In-cident Coronary Artery Disease in Healthy Young and Mid-dle-Aged Adults. Diabetes Care 2014;37:830–8.