New Modifiable Risk Factors Influencing Coronary Artery Disease Severity

Area of Science:

• Cardiology
• Vascular Biology
• Biomarkers

Background:

• Coronary artery disease (CAD) is a leading cause of death globally.
• CAD severity, assessed by the SYNTAX score (SS), impacts patient prognosis and treatment decisions.
• Higher SS correlates with increased major adverse cardiovascular events (MACE).

Purpose of the Study:

• To identify novel risk factors contributing to CAD complexity and severity.
• To explore the role of inflammatory markers, microbiota, vitamin D, and obstructive sleep apnea (OSA) in CAD.
• To inform secondary prevention strategies for coronary atherosclerosis progression.

Main Methods:

• Analysis of established CAD risk factors.
• Investigation of novel indicators including inflammatory parameters (e.g., C-reactive protein), blood smear ratios, uric acid, microbiota alterations, vitamin D levels, and OSA.
• Assessment of indicator significance in different coronary syndrome types (CCSs and ACSs).

Main Results:

• Novel indicators such as inflammatory parameters, uric acid, microbiota alterations, vitamin D deficiency, and OSA significantly predict CAD severity (SS).
• Certain indicators showed significance specifically for chronic coronary syndromes (CCSs) or acute coronary syndromes (ACSs).
• Established risk factors align with coronary plaque burden but novel factors add crucial insights into CAD complexity.

Conclusions:

• Novel risk factors offer a more comprehensive approach to assessing CAD severity beyond traditional indicators.
• An interdisciplinary and translational approach is crucial for integrating these novel findings into clinical practice.
• Improved risk stratification using these novel indicators can enhance secondary prevention efforts for patients with coronary atherosclerosis.