Erken gelişen koroner arter hastalığının değerlendirilmesinde geleneksel risk faktörlerinin prediktif değeri

Year 2019, Volume: 44 Issue: Supplement 1, 190 - 196, 29.12.2019

Fatih Aksoy

https://doi.org/10.17826/cumj.526340

Abstract

Amaç: Bu çalışmanın amacı genç hastalarda koroner arter hastalığının (KAH) sıklığını ve risk faktörlerini değerlendirmektir.

Gereç ve Yöntem: Ocak 2000 - Mart 2016 tarihleri arasında koroner anjiyografi yapılan 21514 hastanın tıbbi kayıtları tarandı. 45 yaşından büyük ve ağır kapak hastalığı olan hastalar çalışma dışı bırakıldı. Çalışmaya toplam 862 hasta dahil edildi. KAH için başlıca risk faktörleri değerlendirilmiştir.

Bulgular: Çalışılan toplam 862 hastanın 595'inde KAH, 267'sinde normal koroner arter (NKA) vardı. genç KAH grubunda erkek yüzdesi (% 94,1 vs. % 58.8) ve sigara içme oranı (% 78 vs. % 45) yaşları açısından benzer olan NKA grubuna göre yüksekti. KAH hastalarında obezite oranı kadınlarda erkeklerden daha yüksek iken (% 41 vs. % 14), sigara içme oranı erkeklerde kadınlara göre daha yüksekti (% 80 vs. % 44). Çok değişkenli analizlere göre erkek cinsiyet [Olasılık Oranı (OO) = 7,3,% 95 Güvenlik aralığı (GA) 4,6-11,4] ve sigara (OO = 2,3,% 95 GA 1,6 – 3,2) KAH'ın bağımsız belirleyicileri olarak bulundu.

Sonuç: Genç erişkinlerde sigara içmenin en önemli risk faktörü olduğunu gösterdik

Keywords

Kardiyovasküler Hastalıklar, genç erişkin, risk faktörleri

Predictive value of traditional risk factors in the assessment of premature coronary artery disease

Abstract

Purpose: The purpose of this study was to assess frequency, risk factors of young patients with coronary artery disease (CAD).

Materials and Methods: Medical recordings of 21514 patients who underwent coronary angiography were screened for this study between January 2000 and March 2016. Patients older than 45 years old and severe valvular disease were excluded study.  A total 862 patients ıncluded study. Major risk factors for CAD were identified. 

Results: Out of total 862 patients studied, 595 had CAD and 267 had normal coronary arteries (NCA).  The young CAD group had a significantly higher proportion of males (94.1 vs. 58.8%) and smokers (78 vs. 45%) than age-matched control patients with NCA. In patients with CAD, the rate of obesity was higher in female group than males (41 vs. 14 %) while the smoking rate was higher than female group (80 vs. 44 %). According to multivariate analysis male sex [Odds ratio (OR) = 7.3, 95% Confidence interval (CI) 4.6- 11.4] and smoking (OR= 2.3, 95% CI 1.6- 3.2) were found to be independent predictors of CAD.

Conclusion: We have shown that smoking was the most important risk factor in young adults

Keywords

Cardiovascular Diseases, young adult, risk factors

References

• 1. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2013:01. cir. 0000441139.02102. 80.
• 2. Rubin JB, Borden WB. Coronary heart disease in young adults. Current atherosclerosis reports. 2012;14(2):140-9.
• 3. Arzamendi D, Benito B, Tizon-Marcos H, Flores J, Tanguay JF, Ly H, et al. Increase in sudden death from coronary artery disease in young adults. American heart journal. 2011;161(3):574-80.
• 4. Chouhan L, Hajar HA, Pomposiello JC. Comparison of thrombolytic therapy for acute myocardial infarction in patients aged< 35 and> 55 years. American Journal of Cardiology. 1993;71(2):157-9.
• 5. Aygül N, Özdemir K, Abacı A, Aygül MÜ, Düzenli MA, Vatankulu MA, et al. Prevalence of risk factors of ST segment elevation myocardial infarction in Turkish patients living in Central Anatolia. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi. 2009;9(1).
• 6. Köz C, Çelebi H, Yokuşoğlu M, Baysan O, Haşimi A, Serdaroğlu M, et al. The relation between coronary lesion distribution and risk factors in young adults. Anatolian Journal of Cardiology/Anadolu Kardiyoloji Dergisi. 2009;9(2).
• 7. Judkins MP. Selective coronary arteriography. I. A percutaneous transfemoral technic. Radiology. 1967;89(5):815-24.
• 8. Cole JH, Miller JI, Sperling LS, Weintraub WS. Long-term follow-up of coronary artery disease presenting in young adults. Journal of the American College of Cardiology. 2003;41(4):521-8.
• 9. Kannel WB, Mcgee DL, Castelli WP. Latest perspectives on cigarette smoking and cardiovascular disease: the Framingham Study. Journal of Cardiac Rehabilitation. 1984;4(7):267-77.
• 10. Rubenfire M, Jackson E. Cardiovascular risk of smoking and benefits of smoking cessation. Up to date. 2010;18.
• 11. Altuntaş I, Dane Ş, Gümüştekin K. Effects of cigarette smoking on lipid peroxidation. Journal of basic and clinical physiology and pharmacology. 2002;13(1):69-72.
• 12. Oliveira A, Barros H, Maciel MJ, Lopes C. Tobacco smoking and acute myocardial infarction in young adults: a population-based case-control study. Preventive medicine. 2007;44(4):311-6.
• 13. Zimmerman FH, Cameron A, Fisher LD, Grace N. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry). Journal of the American College of Cardiology. 1995;26(3):654-61.
• 14. Doughty M, Mehta R, Bruckman D, Das S, Karavite D, Tsai T, et al. Acute myocardial infarction in the young—The University of Michigan experience. American heart journal. 2002;143(1):56-62.
• 15. Schoenenberger AW, Radovanovic D, Stauffer J-C, Windecker S, Urban P, Niedermaier G, et al. Acute coronary syndromes in young patients: presentation, treatment and outcome. International journal of cardiology. 2011;148(3):300-4.
• 16. Prescott E, Hippe M, Schnohr P, Hein HO, Vestbo J. Smoking and risk of myocardial infarction in women and men: longitudinal population study. Bmj. 1998;316(7137):1043.
• 17. Prescott E, Osler M, Anderson PK, Hein HO, Borch-Johnsen K, Lange P, et al. Mortality in women and men in relation to smoking. International journal of epidemiology. 1998;27(1):27-32.
• 18. General US. Youth violence: A report of the Surgeon General. Washington DC: US Department of Health and Human Services. 2001.
• 19. Baron JA, La Vecchia C, Levi F. The antiestrogenic effect of cigarette smoking in women. American journal of obstetrics and gynecology. 1990;162(2):502-14.
• 20. Pineda J, Marín F, Roldán V, Valencia J, Marco P, Sogorb F. Premature myocardial infarction: clinical profile and angiographic findings. International journal of cardiology. 2008;126(1):127-9.
• 21. Sozzi FB, Danzi GB, Foco L, Ferlini M, Tubaro M, Galli M, et al. Myocardial infarction in the young: a sex-based comparison. Coronary artery disease. 2007;18(6):429-31.