CARDIOVASCULAR RISK FACTOR CLUSTERING AND CORONARY ARTERY DISEASE : A 4-YEAR FOLLOW UP STUDY OF 257 SERVICE PERSONNEL

Area of Science:

• Cardiology
• Preventive Medicine
• Public Health

Background:

• Coronary artery disease (CAD) poses a significant health burden.
• Risk factor management is crucial for improving cardiovascular outcomes.
• Silent ischemia, Q-infarction, and non-Q-infarction represent different manifestations of CAD.

Purpose of the Study:

• To evaluate the impact of risk factor intervention on stress test positivity in service personnel with established CAD.
• To assess the improvement rate in stress test results after controlling modifiable risk factors.
• To compare the effectiveness of intervention across different CAD subtypes.

Main Methods:

• A cohort of 257 service personnel with diagnosed CAD (silent ischemia, Q-infarction, non-Q-infarction) and 50 controls underwent stress tests.
• Risk factors including lack of exercise, poor diet, smoking, hypercholesterolemia, alcohol, family history, diabetes, and hypertension were identified and managed.
• Stress tests were repeated after 4 years to assess changes in positivity and improvement rates.

Main Results:

• The primary risk factors identified were lack of exercise (63.0%), dietetic indiscretion (47.4%), and cigarette smoking (40.4%).
• Clustering of risk factors was observed in 61.1% of cases.
• Initial stress test positivity was 83.3%, dropping to 45.9% after 4 years, indicating a 44.9% improvement rate.
• Silent ischemia patients showed the highest improvement (57.8%).
• Only 1.56% of cases experienced deterioration with reinfarction.

Conclusions:

• Aggressive risk factor control leads to significant improvement in cardiac stress test results in service personnel with CAD.
• Intervention strategies are effective in reducing the burden of silent ischemia and improving overall cardiovascular health.
• Long-term risk factor management is essential for preventing adverse cardiac events and improving prognosis.