Relationship between the Severity of Coronary Artery Disease and Cardiovascular Risk Factors in Acute Coronary Syndrome: Based on Tehran Heart Center’s Data Registry

摘要

Background: Acute coronary syndrome (ACS) is one of the main causes of mortality worldwide. We sought to evaluate thecorrelation between the severity of coronary artery disease (CAD) and conventional coronary artery risk factors in a large cohort ofpatients with ACS.Methods: This study included all patients admitted to the coronary care unit with a diagnosis of ACS between 2003 and 2017. Thepatients were divided into 2 groups: 1) unstable angina and 2) myocardial infarction. The aims of this study were to evaluate the effectsof the risk factors and extension of coronary artery stenosis in patients with ACS according to the Gensini score.Results: Of a total 40 319 patients who presented with ACS, 18 862 patients (mean age =60.4±11.14 y, male: 67.2%) underwentconventional coronary angiography and met our criteria to enter the final analysis. The median of the Gensini score was 50 (25–88)in the study population. The multivariable analysis showed that age, sex, diabetes mellitus, hypertension, dyslipidemia, family history,cigarette smoking, opium consumption, and myocardial infarction increased the risk of positive Gensini scores. All the aforementionedrisk factors, except cigarette smoking and opium consumption, increased the severity of stenosis in those with positive Gensini scores.The strongest relationship was seen vis-à-vis myocardial infarction, sex, and diabetes mellitus.Conclusion: Our findings suggest that age, sex, diabetes mellitus, dyslipidemia, hypertension, family history, and myocardialinfarction have significant effects on the severity of CAD. The obesity paradox in relation to CAD should be taken into considerationand needs further investigation in patients with ACS.