Arch Hellen Med, 26(6), November-December 2009, 787-797
The impact of cardiovascular risk factors upon Gensini score. A hospital-based study in Greek patients
V. PEPPES, G. RAMMOS, E. MANIOS, E. KOROBOKI, S. ROKAS, N. ZAKOPOULOS
OBJECTIVE The impact of risk factors on coronary artery disease (CAD) is well established, but there are limited data concerning their association with angiographic findings in the Greek population. The objective of this study was to determine the impact of risk factors on the Gensini score.
METHOD A prospective, case-control study was performed on 124 patients, between 2005 and 2007: 66 cases of acute myocardial infarction (MI), 27 cases of newly diagnosed CAD without MI, and 31 control patients with no evidence of CAD. Cardiovascular risk factors were identified, and patients were submitted to coronary angiography. Statistical analysis was performed by means of the Chi-square test, ANOVA and multivariate logistic regression analysis.
RESULTS A significantly higher incidence of male sex (p<0.001), smoking (p=0.043), hypertension (p=0.05), hyperlipidemia (p<0.001) and a positive family history (p=0.019) was observed in the patients with acute MI and CAD without MI than in the control patients with no abnormalities on coronary angiography. The first two groups had a higher proportion of diabetes mellitus and hyperuricemia than the control subjects, but not to statistically significant degree (p=0.12, p=0.69, respectively). Multivariate logistic regression analysis revealed a significant effect on the Gensini score of male sex (p<0.001), smoking (p<0.001), diabetes mellitus (p<0.001), arterial hypertension (p<0.001), and a positive family history of ischemic heart disease (p<0.001).
CONCLUSIONS A significant effect of cardiovascular risk factors on angiographic evidence of CAD severity and on the Gensini score was demonstrated in this sample of Greek patients investigated in an Athens University department. The risk factors appear to have not only an etiological impact upon CAD development, but also a definite association with disease severity, as evaluated using the Gensini score.
Key words: Cardiovascular risk factors, Coronary angiography, Gensini score.