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2021, Number 3

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Rev cubana med 2021; 60 (3)

Risk factors associated with clinical variants of acute coronary syndrome

Ávila CJA, Fonseca MCA, de la Torre FLM

Language: Spanish
References: 37
Page: 1-15
PDF size: 438.75 Kb.


ABSTRACT

Introduction: Currently, there is a lack of studies that relate cardiovascular risk factors with clinical forms of acute coronary syndrome. If these studies happen, it would be possible to develop more targeted and individualized prevention strategies.
Objective: To identify if there is an association between the clinical forms of acute coronary syndrome and some classic vascular risk factors.
Methods: A cross-sectional analytical observational study was carried out in patients admitted to the coronary care service at “Commandant Manuel Fajardo” Clinical Surgical Hospital from 2013 to 2018. Patients with diagnosis of acute coronary syndrome were included. Data were pulled out from medical records. To test the hypothesis, univariate and multivariate models were used. A value of p ˂ 0.05 was considered significant.
Results: Three hundred ninety three (393) patients were studied, of which 25.7% were diagnosed with acute coronary syndrome with ST segment elevation and 74.3% with acute coronary syndrome without ST segment elevation. In the first group, the median age of the patients was significantly higher (p < 0.001). Smoking was a predictor variable for ST segment elevation (OR: 3.89; 95% CI: 2.24-6.73, p < 0.001). A history of ischemic heart disease (OR: 0.13; 95% CI: 0.07-0.25; p < 0.001) and arterial hypertension (OR: 0.38; 95% CI: 0, were inversely related). 20-0.72; p = 0.003).
Conclusions: It is concluded that smoking is a predictor of acute coronary syndrome with ST segment elevation, while history of ischemic heart disease and arterial hypertension were related to non-ST segment elevation.


REFERENCES

  1. Olshansky SJ, Ault AB. The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases. Milbank Q. 1986;64:355-91.

  2. Ruff CT, Braunwald E. The evolving epidemiology of acute coronary syndrome. Nat Rev Cardiol. 2011[acceso: 01/10/2019];8:140-47. Disponible en: Disponible en: www.nature.com/doifinder/10.1038/nrcardio.2010.199

  3. Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E. Tratado de cardiología de Braunwald. Vol 2. 10ma ed. Barcelona: Elsevier; 2016.

  4. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2018 update. Circulation Research. 2019;139:1-476. Disponible en: https://www.doi.org/10.1116/cir.0000000000000659

  5. WHO. Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2016. Geneva, World Health Organization. 2018[acceso: 20/10/2019]. Disponible en: Disponible en: http://www.who.int/healthinfo/global_burden_disease/GHE2016_Deaths_WHOReg_2000_2016.xls?ua=1

  6. Vedanthan R, Seligman B, Fuster V. Global perspective on acute coronary syndrome. Circulation Research. 2014;114:1959-75. Disponible en: https://doi.org/10.1161/CIRCRESAHA.114.302482

  7. Cuba. Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2017. (Internet). La Habana: MINSAP; 2018[acceso: 01/10/2019]. Disponible en: Disponible en: http://files.sld.cu/dne/files/2018/04/Anuario-Electronico-Espa%C3%B1ol-2017-ed-2018.pdf

  8. Ettehad D, Emdin CA, Kiran A, Anderson SG, Callender T, Emberson J, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016;387:957-67. Disponible en: https://dx.doi.org/10.1016/S0140-6736(15)01225-8

  9. Paneni F, Beckman JA, Creager MA, Cosentino F. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part 1. Eur Heart J. 2013;34:2436-43.

  10. Afshar M, Pilote L, Dufresne L, Engert JC, Thanassoulis G. Lipoprotein(a) interactions with low-density lipoprotein cholesterol and other cardiovascular risk factors in premature acute coronary syndrome. J Am Heart Assoc. 2016;5:e003012. Disponible en: http://dx.doi.org/doi:10.1161/JAHA.115.003012

  11. Hammal, F, Ezekowitz, J, Norris, CM, Wild, TC, Finegan, BA. Smoking status and survival: impact on mortality of continuing to smoke one year after the angiographic diagnosis of coronary artery disease, a prospective cohort study. Cardiovascular Disorders. 2014;14:133-8.

  12. Yeh RW, Sidney S, Chandra M, Sorel M, Selby JV, Go AS. Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med. 2010[acceso: 02/10/2019];362:2155-65. Disponible en: Disponible en: https://www.nejm.org/doi/pdf/10.1056/NEJMoa0908610

  13. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation. 2015[acceso: 01/10/2019];131(4):e29-322. Disponible en: Disponible en: https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000157

  14. Giugliano RP, Braunwald E. The year in acute coronary syndrome. J Am Col Cardiol. 2014;63(3):201-14. Disponible en: http://dx.doi.org/10.1016/j.jacc.2013.10.041

  15. Grupo de Trabajo de la Sociedad Europea de Cardiología (ESC) para el tratamiento del infarto agudo de miocardio en pacientes con elevación del segmento ST. Guía ESC 2017 sobre el tratamiento del infarto agudo de miocardio en pacientes con elevación del segmento ST. Rev Esp Cardiol. 2017;70(12):1082.e1-e61. Disponible en: http://dx.doi.org/1100..1100116/6/j.rj.recesp.20ecesp.201177..110.00.04498

  16. Grupo de Trabajo de la Sociedad Europea de Cardiología (ESC) para el tratamiento de los síndromes coronarios agudos en pacientes sin elevación persistente del segmento ST. Guía ESC 2015 sobre el tratamiento de los síndromes coronarios agudos en pacientes sin elevación persistente del segmento ST. Rev Esp Cardiol. 2015;65(12):1125.e1-e64. Disponible en: http://dx.doi.org/10.1016/j.recesp.2015.10.012

  17. Pérez Caballero MD, León Álvarez JL, Dueñas Herrera A, Alfonzo Guerra JP, Navarro Despaigne DA, de la Noval García R, et al. Guía cubana de diagnóstico, evaluación y tratamiento de la hipertensión arterial. Rev Cubana Med. 2017[acceso: 05/10/2019];56(4):242-321. Disponible en: Disponible en: http://scielo.sld.cu/pdf/med/v56n4/med01417.pdf

  18. American Diabetes Association. Standards of medical care in diabetes 2014. Diabetes care. 2015[acceso: 01/10/2019];38(Suppl 1):S8-S16. Disponible en: Disponible en: http://care.diabetesjournals.org/content/37/Supplement_1/S14?ijkey=17b89138213bba04

  19. Masson W, Siniawski D, Krauss J, Cagide A. Clinical Applicability of the Framingham 30-Year Risk Score. Usefulness in Cardiovascular Risk Stratification and the Diagnosis of Carotid Atherosclerotic Plaque. Rev Esp Cardiol. 2011[acceso: 01/10/2019];64(4). Disponible en: Disponible en: http://www.sciencedirect.com/science/article/pii/S1885585711001332

  20. Organización Mundial de la Salud. Prevención de las enfermedades cardiovasculares. Guía de bolsillo para estimación y el manejo del riesgo cardiovascular. Ginebra; OMS; 2008.

  21. Gibbons GH, Harold JG, Jessup M, Robertson RM, Oetgen W. Next Steps in Developing Clinical Practice Guidelines for Prevention. Circulation (Internet). 2013[acceso: 01/10/2019];128:1716-1717. Disponible en: Disponible en: https://www.ahajournals.org/doi/10.1161/circulationaha.113.005548

  22. Vahia VN. Diagnostic and statistical manual of mental disorders 5: A quick glance. Indian J Psychiatry. 2013;55(3):220-223. Disponible en: https://doi.org/:10.4103/0019-5545.117131

  23. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. The Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth universal definition of myocardial infarction (2018). Circulation (Internet). 2018[acceso: 01/10/2019];138:618-51. Disponible en: https://doi.org/10.1161/CIR.0000000000000617

  24. Barua RS, Ambrose JA. Mechanisms of coronary thrombosis in cigarette smoke exposure. Arterioscler Thromb Vasc Biol (Internet). 2013[acceso: 01/10/2019];33:1460-67. Disponible en: Disponible en: https://www.ahajournals.org/doi/full/10.1161/atvbaha.112.300154

  25. Csordas A, Bernhard D. The biology behind the atherothrombotic effects of cigarette smoke. Nat Rev Cardiol (Internet). 2014[acceso: 02/10/2019];10:219-30. Disponible en: Disponible en: https://europepmc.org/article/med/23380975

  26. Boyer M, Lévesque V, Poirier P, Marette A, Mitchell PL, Mora S, et al. Longitudinal changes in cholesterol efflux capacities in patients with coronary artery disease undergoing lifestyle modification therapy. J Am Heart Assoc. 2018;7:e008681. Disponible en: http://doi.org/10.1161/JAHA.118.008681

  27. Chen H, Wang C, Wang J. Nicotine induce mast cells degranulation to increase macrophage migration and promote foam cell formation. J Am Col Card (Internet). 2017[acceso: 02/10/2019];70(16):Suppl C.GW28-e0805. Disponible en: Disponible en: https://www.jacc.org/doi/pdf/10.1016/j.jacc.2017.07.176

  28. Boswijk E, Bauwens M, Mottaghy FM, Wildberger JE, Bucerius J. Potential of α7 nicotinic acetylcholine receptor PET imaging in atherosclerosis. Methods (Internet). 2017[acceso: 02/10/2019];130:90-104. Disponible en: https://doi.org/10.1016/j.ymeth.2017.06.008

  29. Kianoush S, Yakoob MY, Al-Rifai M, DeFilippis AP, Bittencourt MS, Duncan BB. Associations of Cigarrete Smoking with Subclinical Inflammation and Atherosclerosis: ELSA-Brasil (The Brazilian Longitudinal Study of Adult Health). J Am Heart Assoc. 2017;6: e005088. Disponible en: http://doi.org/10.1161/jaha.116.005088

  30. Kianoush S, Bittencourt MS, Lotufo PA, Bensensor IM, Jones SR, DeFilippis AP. Association Between Smoking and Serum GlycA and High-Sensitivity C-Reactive Protein Levels: The Multi-Ethnic Study of Atherosclerosis (MESA) and Brazilian Longitudinal of Adult Health (ELSA-Brasil). J Am Heart Assoc. 2017;6:e006545. Disponible en: http://doi.org/10.1161/jaha.117.006545

  31. McEvoy JW, Nasir K, DeFilippis AP, Lima JA, Bluemke DA, Hundley WG, et al. Relationship of cigarette smoking with inflammation and subclinical vascular disease the Multi-Ethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol. 2015;35:1002-10.

  32. Canty JM, Duncker DJ. Flujo sanguíneo coronario e isquemia miocárdica. En: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E. Braunwald´s Heart Disease. A Textbook of Cardiovascular Medicine. 10ma ed. España: Elsevier; 2015. p. 873-890.

  33. Marín F, Prada M. Relación del tabaquismo como factor de riesgo para el tipo de evento coronario agudo (IAM vs angina inestable) en 1592 pacientes. Rev Col Cardiol. 2003;10(7):391-97.

  34. Fadini RB, Takáo RC, Ruiz ZC, Batista SV, Lima LJ, Botura LB. Asociación de factores de riesgo cardiovasculares con las diferentes presentaciones del síndrome coronario agudo. Rev Latino-Am Enfermagem. 2014[acceso: 02/10/2019];22(4):538-46. Disponible en: Disponible en: https://www.scielo.br/j/rlae/a/FD7HWG4w5j3WL3GbR4vzpzC/?format=pdf&lang=es

  35. Carbajosa DJ, Llorens P, Diéguez ZS, Carratalá PJ, Díaz DJ, Martínez BE, et al. Influencia del sexo del paciente en el manejo del síndrome coronario agudo con elevación del ST en los servicios de urgencia. Emergencias. 2011;23:87-92.

  36. Borda-Velásquez L, Razzeto-Rubio L, Rey-Mendoza J, Medina F, Mormontoy W. Estrategias de reperfusión usadas en pacientes con síndrome coronario agudo con elevación persistente del segmento ST en un hospital general. Rev Med Hered. 2015;26(1):77-86.

  37. Caraballoso GL, Caraballoso GV, Orea CI, Solis PD. Estrategia invasiva, inmediata, mediata y tardía en el síndrome coronario agudo sin elevación del ST. CorSalud. 2018[acceso: 01/10/2019];10(3):192-201. Disponible en: Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2078-71702018000300003




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