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Cardiovascular risk factors associated with clinically isolated and diffuse atherosclerosis in Spanish patients with
J F Meco1, X Pintó, J M Escribà
1Bellvitge Hospital, Barcelona, Spain.
Insights
Diffuse atherosclerosis, common in older patients, is linked to hypertension and diabetes. This condition, involving coronary, peripheral, and cerebrovascular disease, increases mortality risk.
Area of Science:
- Cardiovascular Medicine
- Atherosclerosis Research
- Public Health
Background:
- Patients with coronary artery disease (CAD) and associated peripheral (PAD) or cerebrovascular disease (CVD) have diffuse atherosclerosis, posing a higher mortality risk than isolated CAD.
- The prevalence and risk factors of diffuse atherosclerosis in specific geographic regions remain underexplored.
Purpose of the Study:
- To determine the prevalence of diffuse atherosclerosis in patients admitted for acute coronary syndromes.
- To identify atherogenic risk factors associated with diffuse atherosclerosis in this patient cohort.
Main Methods:
- A cohort of 2597 patients admitted for acute coronary syndromes were analyzed.
- Patients were categorized into diffuse atherosclerosis (with PAD or CVD) and isolated CAD groups.
- Baseline history, physical data, and lipid profiles were collected.
Main Results:
- 14.2% of patients (370) exhibited diffuse atherosclerosis.
- Diffuse atherosclerosis patients were older, more frequently hypertensive, diabetic, and former smokers.
- Key risk factors identified included age >55, hypertension, diabetes, former smoking status, and a low HDL-C/TC ratio.
Conclusions:
- Clinically evident diffuse atherosclerosis is a significant condition, affecting a notable portion of cardiovascular patients.
- Older age, hypertension, diabetes, and a low HDL-C/TC ratio are strongly associated with diffuse atherosclerosis.
Background:
Patients with coronary artery disease (CAD) associated with peripheral (PAD) or cerebrovascular disease (CVD), a condition called diffuse atherosclerosis, have a higher risk of death than patients with isolated CAD. The prevalence of diffuse atherosclerosis and the atherogenic risk factors associated with this condition in our geographic area have not been described previously.
Methods:
A cohort of 2597 patients (62 +/- 10.8 years, 665 women) consecutively admitted at Bellvitge Hospital because of acute coronary syndromes were studied. CAD patients were divided in two groups with diffuse and located atherosclerosis according to whether they had or they had not an associated PAD or CVD. Baseline history, physical data and lipid profile were recorded in each patient according to a standardized questionnaire.
Results:
A total of 370 patients (14.2%) had diffuse atherosclerosis. Among them, there were more men and women older than 55 years than among those with isolated CAD. Patients with diffuse atherosclerosis were more frequently hypertensive, diabetic and former smokers than those with isolated CAD (60.5% vs. 49.4%, P < 0.01; 37.4% vs. 24.5%, P < 0.01; and 47% vs. 35.7%, P < 0.01, respectively). There were no significant differences in the mean values of total cholesterol (TC), low-density cholesterol (LDL-C), high-density cholesterol (HDL-C) and triglycerides between both groups of patients, but patients with diffuse atherosclerosis had a lower HDL-C/TC ratio, with borderline statistical significance (0.18 +/- 0.06 vs. 0.19 +/- 0.06, P = 0.06). Using multiple logistic regression analysis, the variables associated with diffuse atherosclerosis in men were age greater than 55 years (OR 1.97, CI 1.33-2.93), hypertension (OR 1.50, CI 1.14-2.20), diabetes (OR 1.78, CI 1.20-2.70), smoking (former smokers) (OR 2.09, CI 1.36-3.24) and HDL-C/TC < 0.20 (OR 1.60, CI 1.18-2.17); and in women hypertension (OR 3.43, CI 1.48-7.94) and diabetes (OR 2.58, CI 1.55-4.80).
Conclusions:
Clinically overt diffuse atherosclerosis is a relatively common disease. Older patients and those with hypertension, diabetes or low HDL-C/TC ratio are more likely to have diffuse atherosclerosis than those without these conditions.