Prediction of the significance of coronary arterial lesions by the assessment of the cardiovasular risk factors in patients with "NON-ST elevated myocardial infarction" in Manisa region

In our study we evaluated the relationship between classical cardiovascular risk factors and severity of coronary lesions in a group of patients hospitalized for non-ST-segment elevation myocardial infarction (NSTEMI). For this purpose, records of 222 patients (82 female, 140 male) living in the Manisa region who were hospitalized in Celal Bayar University for NSTEMI during 2012–2014 were reviewed retrospectively. Mean age was 64.81 ± 12.63 years (range 31–113 years); all patients underwent coronary angiography using the Judkins method. Severity of the coronary artery disease and distribut ion of lesions were evaluated using the coronary artery score and the Gensini scoring system. We compared the results of these scores and their relation to classical cardiovascular risk factors (male gender, diabetes mellitus (DM), hypertension (HT), smoking history, chronic renal failure (CRF), dyslipidemia(DL). Patients below the age of 18 and those with a previous coronary artery bypass graft were excluded from the study; all others were included. We found that in male patients hospitalized and examined for NSTEMI, classical coronary risk factors such as male gender, DM, HT, smoking, and CRF significantly increased the severity of the coronary artery disease. Also, we observed that dyslipidemia shows a proportional increase in relation to severity of the coronary artery disease; however, this was not statistically significant. We hypothesize that because patients who are being treated for dyslipidemia are also included in the dyslipidemia group regardless of their lipid levels, and because statins have pleotrophic effects in addition to their lipid lowering properties, statistical significance was lacking. Coexisting classical risk factors increased the relative (numerical) severity of coronary artery disease. Severity was statistically significant in the DM+HT and DL+smoking groups, but there was no statistically significant relationship in the DM+HT+DL, HT+DL+smoking, or HT+DM+DL+smoking groups. Although ischemic cerebrovascular accident (CVA) is not considered a classical cardiovascular risk factor, we also evaluated this group in our study. Although coronary artery disease severity was proportionally (numerically) higher in CVA group, it did not reach statistically significance. Due to the limited number of patients in this group in our study, which resulted in too low a power to be definitive, the results of other studies in this area should be considered. When the results of the present study are taken into consideration, we can conclude that optimal treatment of changeable classical cardiovascular risk factors is crucial for lowering the mortality and morbidity related to cardiovascular events.