The role of candidate markers in prediction of all-cause and cardiovascular disease mortality in coronary angiography patients.

摘要

Predictive influences of the prognostic factors on three mortality end points (all-cause, cardiovascular disease (CVD) and coronary artery disease (CAD) mortality) were examined in 528 patients with symptomatic CAD who underwent cardiac catheterizations from November 1992 through March 1994 at the Veterans Administration (VA) Medical Center (Oklahoma City, OK) by following them for eight years. Information on prognostic factors was collected at the time of the catheterizations from medical records and by laboratory measurement of blood samples. Vital status information was obtained from the official records from Oklahoma State Department of Health. Information on medications and surgical Analyses were conducted on 399 males (247 survived and 152 died) by using Cox Proportional Hazards modeling techniques. Patients were classified in age groups according to their ages at the time of the catheterization. All-cause mortality was positively related to high levels of serum fibrinogen, triglycerides, total cholesterol and obesity. The prescriptions of lipid lowering drugs, beta-blockers and aspirin, the performance of percutaneous transluminal coronary angioplasty (PTCA) and quitting smoking were protective factors. CVD mortality was positively related to the presence of baseline CAD by a 50% stenosis threshold, occurrence of MI during the follow-up period and fibrinogen levels. Protective effects were seen for the prescription of lipid-lowering drugs and beta-blockers, quitting smoking and the performance of PTCA. CAD mortality was positively related to high fibrinogen and triglycerides levels, occurrence of MI during the follow-up period and diabetes. The performance of PTCA and prescription of lipid lowering drugs and beta-blockers were protective. Some of these factors were important in younger age groups; some were important in older age groups, while some were important in all age groups.; A small set of CAD risk factors can help in the prediction of all-cause, CVD and CAD mortality among CAD patients of different ages. Most of the punitive risk factors identified here are modifiable, and certain medical and surgical interventions are seen to be protective, therefore a combination of preventive, medical and surgical strategies may reduce the risk of CVD and CAD mortality, and may improve the overall survival of male military veterans with CAD symptomatology.