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Is the Number of Coronary Risk Factors a Predictor of the Severity of Early Coronary Disease?

Accessible online at: www.karger.com/journals/crd Dear Sir, Multiple risk factors have a synergistic effect on morbidity and mortality from coronary heart disease in middle age and later, as has been demonstrated by epidemiologic studies such as the Framingham Study [1]. Berenson et al. [2] found that the extent of atherosclerotic lesions in coronary vessels was markedly increased in young people with multiple risk factors. The risk factors that predict these early atherosclerotic lesions in children and young adults are the same as those that predict cardiovascular events among middle-aged and older adults. To determine whether the number of coronary risk factors is related to the severity of coronary disease in males with early coronary heart disease, a group of 230 male patients younger than 50 years (mean age 43 B 5 years) who had been admitted to our Coronary Care Unit as the result of an episode of coronary disease were consecutively studied. In the acute phase, by means of a structured questionnaire, the presence of smoking habits, hypertension, diabetes and dyslipemia was determined. A physical examination and fasting analysis were also performed. Due to clinical instability or persistent myocardial ischemia, 132 patients underwent a cardiac catheterization. The number of coronary risk factors and the number of affected vessels were considered. Due to the small number of subjects in some of the groups, some of them were grouped together. Those subjects with no risk factor or only one were studied together (group 1). Those who presented more than one risk factor were also studied together (group 2). Those patients with normal coronariography and single-vessel disease were also grouped. For statistical analysis, the ̄2 test was applied. The results are summarized in table 1. We conclude that patients with earlyonset coronary disease and with more than one coronary risk factor have a greater frequency of multivessel disease than those patients who present none or only one coronary risk factor. References