Extent of coronary artery disease in patients undergoing angiography for stable or acute coronary syndromes

Hellenic Journal of Cardiology

卷:58

Konstantinos Vakalis¹  Georgios Triantis²  Dimitrios Sionis²  Constantina Gartzonika³  Georgios Chasiotis⁴  Eleni Bairaktari⁴  Sophia Giannitsi⁵  Lampros K. Michalis⁵  Katerina K. Naka⁵  Emorfili Ioanna Antoniadou⁵  Christos S. Katsouras⁵  Aris Bechlioulis⁵  Mara Bougiakli⁵  Aikaterini Marini⁵  Konstantina Nikolaou⁵ 

[1] 2nd Department of Cardiology, University of Ioannina, Ioannina, Greece;

[2] Department of Cardiology, Sismanoglion Hospital, Athens, Greece;

[3] Department of Microbiology, University of Ioannina, Ioannina, Greece;

[4] Laboratory of Biochemistry, University Hospital of Ioannina, Ioannina, Greece;

[5] Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece;

关键词: Risk factors;    Inflammation;    Gensini score;    Coronary atherosclerosis;    Coronary angiography;   

DOI  :  10.1016/j.hjc.2016.08.004

来源: DOAJ

【 摘 要 】

Background: We aimed to investigate whether the angiographic extent of coronary artery disease (CAD) differs in patients undergoing coronary angiography for stable CAD or acute coronary syndrome (ACS) and identify predictors of CAD extent in these patients.Methods: We enrolled 584 consecutive patients (463 with stable CAD, 121 with ACS) with angiographically established CAD (≥1 stenosis >25%). The Gensini score was used to assess the extent of coronary atherosclerosis.Results: Stable CAD patients had greater Framingham risk score and greater prevalence of hypertension, hypercholesterolemia, and diabetes (p<0.05 for all). Fasting glucose and systolic and diastolic blood pressure were higher, while high-sensitivity C-reactive protein (hsCRP) levels were lower in patients with stable CAD than in those with ACS (p<0.05 for all). No difference in Gensini score was observed between the two groups (p=0.118), but patients with ACS were more likely to have at least one significant epicardial angiographic lesion (>50% stenosis) (OR 2.0, p=0.022). Higher Gensini score was independently associated with (i) higher hsCRP and glucose levels, hypercholesterolemia, and increased age in stable CAD patients (R2 0.15, p<0001) and (ii) increased age and higher glucose and hsCRP levels in patients with ACS (R2 0.17, p<0001).Conclusions: Patients undergoing coronary angiography for ACS or stable CAD presented with a similar extent of angiographic CAD, although patients with ACS had a higher prevalence of significant lesions in the presence of a better cardiovascular risk profile and higher inflammation levels. The extent of angiographic CAD in both the groups shared common determinants such as hsCRP, age, and hyperglycemia, but these appeared to explain only a small part of the variation of coronary atherosclerosis.

【 授权许可】

Unknown