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[Coronarography in 1000 consecutive patients--clinical aspects]
Z Dzielińska1, B Górecka, M Dabrowski
1Kliniki Kardiologii Ogólnej i II Samodzielnej Pracowni Hemodynamicznej Instytutu Kardiologii w Warszawie.
Insights
This study found that older patients with ischemic heart disease have more severe coronary artery stenosis. Age significantly correlates with the number of narrowed coronary arteries, with diffuse atherosclerosis more common in those over 40.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Ischemic heart disease (IHD) is a major cause of morbidity and mortality.
- Atherosclerotic changes in coronary arteries are the primary pathology in IHD.
- Understanding the relationship between patient age and coronary atherosclerosis severity is crucial for risk stratification and treatment planning.
Purpose of the Study:
- To assess the prevalence and severity of atherosclerotic lesions in the main coronary arteries.
- To investigate the correlation between patient age and the extent of coronary artery stenosis.
- To analyze the impact of age on the pattern of coronary atherosclerosis.
Main Methods:
- Selective coronarography and left ventriculography were performed on 1000 patients with suspected IHD.
- Coronary arteries were assessed for stenosis exceeding 50% of lumen diameter.
- Patients were analyzed in age subgroups (younger and older than 40 years).
Main Results:
- Significant coronary artery stenosis was present in a majority of patients (7.7% no stenosis, 14.5% single artery, 32.8% single significant, 28.5% two arteries, 10.1% three arteries).
- A statistically significant correlation was found between patient age and the number of coronary artery stenoses.
- Diffuse coronary atherosclerosis was more prevalent in patients over 40 years, while younger patients predominantly showed single-artery involvement.
Conclusions:
- Patient age is a significant factor influencing the extent and pattern of coronary artery atherosclerosis.
- Older individuals (>40 years) tend to exhibit more widespread and severe coronary artery disease.
- These findings highlight the importance of age in the evaluation and management of ischemic heart disease.
Abstract:
Between 1984 and 1987 1000 consecutive patients with stated or suspected ischemic heart disease underwent selective coronarography and left ventriculography. Patient's age ranged from 23 to 70 years (mean - 47 yrs). Atherosclerotic lesions in three main coronary arteries: left anterior descending, circumflex and right coronary artery were assessed. Stenosis exceeding 50% of a vessel lumen was considered as a significant one. Changes were evaluated in the whole group of patients and in two subgroups in relation to patients age (younger and older than 40 years). Besides assessment of atherosclerotic changes in coronary arteries a presence of IHD risk factors, family occurrence, disease progress and methods of further therapy were analyzed. 60.9% of patients had a documented history of myocardial infarction in the post. Unchanged coronary arteries were found in 77 patients (7.7%), one isolated coronary artery stenosis in 145, single coronary artery stenosis with nonsignificant atherosclerotic lesions in other arteries in 328. Two significantly narrowed arteries were found in 285 patients and 101 subjects had significant changes in three coronary arteries. Analysis of further therapy revealed following results: 520 patients underwent PTCA or CABG (270 - PTCA and 250 - CABG), 439 were conservatively treated and only 41 did not need further cardiological care. Comparing atherosclerotic changes in patients younger and older than 40 years, a statistically significant correlation between patient's age and a number of coronary artery stenosis was stated. Diffuse coronary atherosclerosis more frequently occurred in patients more than 40 years. In youngers changes mainly concern a single coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)