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Risk factors for atherosclerosis--can they be used to identify the patient with multisystem atherosclerosis?
A M Travers1, J M van Zyl, C J Nel
1Department of Surgery, Universitas Hospital, Bloemfontein.
Insights
Identifying atherosclerosis risk factors aids in early detection and screening. Key indicators include family history, existing arterial disease, and elevated lipid levels, improving diagnostic accuracy.
Area of Science:
- Cardiovascular Medicine
- Medical Diagnostics
- Public Health
Background:
- Atherosclerosis risk factors are crucial for preventive care and identifying patients at high risk.
- These factors also correlate with the presence of existing atherosclerosis, aiding in screening for additional disease in known arteriopaths.
Purpose of the Study:
- To investigate the association between known risk factors and the presence of additional atherosclerotic disease in patients admitted with various atherosclerotic conditions.
- To evaluate the predictive value of specific risk factors for concomitant atherosclerosis in different patient cohorts.
Main Methods:
- Retrospective analysis of 471 patients admitted with symptoms of atherosclerosis.
- Logistic regression was used to identify significant risk factors and calculate odds ratios.
- Sensitivity and specificity were determined for predictive models based on identified risk factors.
Main Results:
- In peripheral vascular disease patients, risk factors for coronary artery disease included family history of ischemic heart disease (OR=2.6), carotid artery disease (OR=1.9), and high triglycerides (P<0.04).
- In carotid artery disease patients, risk factors for ischemic heart disease included peripheral vascular disease (OR=1.9) and high cholesterol (P<0.02).
- In acute myocardial infarction/coronary artery bypass surgery patients, female gender (OR=2.9) and increased age (P<0.001) predicted additional atherosclerosis.
Conclusions:
- Specific risk factor combinations can predict additional atherosclerotic disease in patients presenting with various forms of atherosclerosis.
- Risk factor profiles vary depending on the primary atherosclerotic condition, necessitating tailored screening approaches.
- Logistic regression models incorporating age demonstrated moderate sensitivity and high specificity for predicting additional atherosclerosis in certain patient groups.
Abstract:
Risk factors are often used in preventive care programmes to identify the patient at particular risk for developing atherosclerosis. Risk factors for atherosclerosis have also been shown to be linked to the presence of the disease at a given time, a fact that may be helpful when screening for additional atherosclerotic disease in the known arteriopath. Risk factors were recorded in 471 patients admitted to hospital with symptoms of atherosclerosis. In patients admitted primarily with peripheral vascular disease, risk factors linked to the presence of additional coronary artery disease were a family history of ischaemic heart disease (odds ratio = 2.6), the presence of carotid artery disease (odds ratio = 1.9) and high fasting serum triglyceride levels (P less than 0.04). Grouping these factors together using logistic regression, ischaemic heart disease could be predicted with a sensitivity of 72% and a specificity of 43%. Patients admitted with carotid artery disease were more likely to have ischaemic heart disease in the presence of peripheral vascular disease (odds ratio = 1.9) and a raised serum cholesterol level (P less than 0.02), while female gender (odds ratio = 2.9) and an increase in age (P less than 0.001) were linked to an increased prevalence of concomitant atherosclerosis in patients admitted with acute myocardial infarction or for elective coronary artery bypass surgery. Using an age cut-off point, additional atherosclerosis could be predicted with a sensitivity of 32% and a specificity of 88% in these patients.