Relationship between individual cardiovascular risk factors and localization of coronary atherosclerotic lesions

Trianti, Myrto; Xanthos, Theodoros; Iacovidou, Nicoletta; Dagres, Nikolaos; Lekakis, John P.; Kyriakou, Fani; Kremastinos, Dimitrios T.

doi:10.1016/j.hrtlng.2010.06.007

« Previous Next »Heart & Lung: The Journal of Acute and Critical Care
Volume 40, Issue 3 , Pages 201-207, May 2011

Relationship between individual cardiovascular risk factors and localization of coronary atherosclerotic lesions

Myrto Trianti, MD
- Department of Pneumology, 401 General Military Hospital, Athens, Greece
Theodoros Xanthos, MD
- Department of Experimental Surgery and Surgical Research “N.S. Christeas,” University of Athens, Greece
Nicoletta Iacovidou, MD
- Neonatal Division, Second Department of Obstetrics and Gynecology, Athens University Medical School, Athens, Greece
Nikolaos Dagres, MD
- Second Department of Cardiology, University of Athens, ATTIKON University Hospital, Athens, Greece
- Corresponding author: Nikolaos Dagres, MD, Second University Cardiology Department, Attikon University Hospital, Rimini 1, Haidari, 12462 Athens, Greece.
John P. Lekakis, MD
- Second Department of Cardiology, University of Athens, ATTIKON University Hospital, Athens, Greece
Fani Kyriakou, MD
- Critical Care Department, University of Athens, Evangelismos General Hospital, Athens, Greece
Dimitrios T. Kremastinos, MD
- Second Department of Cardiology, University of Athens, ATTIKON University Hospital, Athens, Greece

Received 10 October 2009; received in revised form 3 June 2010; accepted 15 June 2010. published online 26 August 2010.

Abstract

Objective

The localization of coronary atherosclerotic lesions in patients with coronary artery disease is important. We investigated the relationship between individual cardiovascular risk factors and lesion localization in the coronary arteries.

Methods

We studied 200 consecutive patients with suspected or known coronary artery disease who were referred for coronary angiography because of chest pain. We assessed the following cardiovascular risk factors: male gender, hypercholesterolemia, smoking, arterial hypertension, positive family history, and diabetes. We evaluated atherosclerotic lesions creating a stenosis ≥ 50% in the 3 coronary arteries and lesions creating a stenosis ≥ 30% in the left main stem.

Results

Of the 200 study patients, 155 (78%) showed at least 1 coronary artery lesion with a luminal stenosis ≥ 50%. With an increasing number of risk factors, there was a significant progressive increase of diseased arteries (P < .001). There was a differential association between individual risk factors and lesions in the 3 coronary arteries. Male gender, hypercholesterolemia, and diabetes were predictors of lesions in the left anterior descending artery (odds ratios 2.365, 2.510, and 1.998, respectively). Predictors of left circumflex artery lesions were male gender, smoking, and diabetes (odds ratios 2.581, 1.913, and 2.280, respectively), whereas the only independent predictor of right coronary artery lesions was male gender (odds ratio 2.995). Diabetes was also significantly associated with lesions in the diagonal branches of the left anterior descending artery and the marginal branches of the left circumflex artery.