مرکز منطقه ای اطلاع رساني علوم و فناوري - تخمين خطر نسبي و مطلق بيماري كرونر قلب از روي عوامل خطرساز اصلي با استفاده از ارزش هاي فرامينگهام

چكيده لاتين :

Background and purpose: Coronary heart disease (CHD) is a multifactorial disorder with over 250 different known risk factors. Advancing age, male gender, dyslipidemia, hypertension, diabetes mellitus and cigarette smoking are the major and independent risk factors for CHD. The aim of the present study was to assess the association between anthropometric and clinically observed variables relative to the severity of CHD in 260 angiographic defined patients. Methods and Materials: Subjects with one or more lesion that narrowed the lumen of any coronary artery more than 70% were considered to be CHD cases, whereas those without any significant narrowing (510%) were taken as controls. The severity of coronary occlusion was scored on the bases of the number and the extent of lesions. Fasting serum concentrations of glucose, triglycerides, total and HDL cholesterol were determined. Anthropometrics parameters were collected by questionnaires. The Framingham scores, relative and absolute risks for CHD were calculated on the basis of the Framinghamʹs points for the major risk factors. Results: The group with CHD was older than the group without CHD (57.0 ± 10.2 vs. 51.1 ± 10.3, P<0.000). CHD was more prevalent in men than women (78.2% vs. 51.6%, P.<0.000). There was no statistically significant difference between two groups in body mass index, education and systolic and diastolic blood pressures. The prevalence of hypertension, physical inactivity, cigarette smoking, and diabetes mellitus was more in CHD^+ cases than controls. Patients with CHD compared with the controls had increased serum levels of triglycerides (231.7 ± 180.1 vs. 176.3 ± 101.9, P_• 0.003), total cholesterol (205.2 ± 60.8 vs. 193.9 ± 41.0, P<_ 0.08), LDL cholesterol (128.8 ± 59.2 vs. 119.8 ± 33.6, P< 0.2) and decreased serum levels of HDL cholesterol (42.3 ± 13.3 vs. 39.7 ± 11.3, P< 0.1). The higher prevalence of major cardiovasular risk factors were found in the subgroup of patients with more extensive CHD. The Framingham scores (8.7 ± 4.4 vs. 5.7 ± 4.8, P50.000), relative risk (2.5 ± 1.3 vs. 1.6 ± 0.7, P•_0.000) and absolute risk (14.8 ± 8.6 vs. 8.1 ± 6.7, P<0.000) were higher in CHD patients than controls. On multiple logistic regression analysis, the best markers for discriminating between CHD and control subjects were age (OR=1.06, P<0.001), male gender (OR=4.51, P50.000), smoking (OR=3.56, P<0.05), diabetes mellitus (OR=7.76, P<0.000) and cholesterol (OR=1.009, P.0.02). Conclusion: The results suggest that the major cardiovascular risk factors and Framinghamʹs risk scores are associated to the severity of CHD continuously and graded.