The impact of cardiovascular risk factors on the site and extent of coronary artery disease

BACKGROUND: In patients with coronary artery disease (CAD), the site and extent of coronary artery involvement in terms of proximal versus distal stenosis and multi- versus single-vessel disease have a crucial effect on patients’ outcome. This study was designed to evaluate the relationship between cardiovascular risk factors and the site and extent of coronary artery involvement. METHODS: In this study of patients who had undergone coronary angiography in our hospital, 125 with proximal lesions were enrolled as the case group (group 1) and an equal age-and gender-matched number of patients with non-proximal lesions were selected as the control group (group 2). The two groups were compared based on the presence or absence of diabetes mellitus (DM), hypercholesterolaemia, hypertriglyceridaemia, hypertension (HTN) and cigarette smoking. RESULTS: The frequency of DM was 33.6 and 10.4% in the case and control groups, respectively, which was statistically significant (p < 0.0001). However, the frequency of hypercholesterolaemia in the case and control groups was 30.4 and 29.6% (p = 0.89), respectively; for hypertriglyceridaemia it was 19.2 and 16.8% (p = 0.062), respectively; for HTN it was 33.6 and 28.8% (p = 0.4), respectively; and for cigarette smoking it was 28.8 and 39.2% (p = 0.08), respectively, which were not statistically significant. Diabetic patients compared to non-diabetics had more multi-vessel disease (89.1 vs 61%, p < 0.0001, respectively), which was statistically significant. There was no relationship between hypercholesterolaemia, hypertriglyceridaemia, HTN and cigarette smoking and extent (multi-vessel involvement) of CAD (p = NS). CONCLUSION: Proximal and multi-vessel involvement of the coronary arteries in patients with CAD was related to a history of DM but not of hypercholesterolaemia, HTN, cigarette smoking and hypertiglyceridaemia.