Correlation between Coronary Risk Factors and Severity of Coronary Artery Disease

BACKGROUND: Coronary artery disease(CAD) has been related to a number of factors, including diabetes, smoking,hypertension, blood lipids, and family history of CAD. However, a few studies have examined the correlation between these factors and severity of CAD. In the present study, we aimed to define the correlation between risk factors and the severity of CAD. METHODS: The study population was 309 consecutive patients who underwent coronary angiography in Kang Nam St. Marys hospital between Mar. 1992 and Aug. 1994. We analyzed risk factors of CA ; age, total cholesterol(TC), triglyceride, high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol cholesterol(LDL-C), the ratio of TC to HDL-C, Lp(a), uric acid, fibrinogen, diabetes, hypertension, smoking, and family history of CAD. All films were reviewed without specific knowledge of blood laboratory results. Significant occlusive disease was defined as >50% diameter obstruction of a major coronary vessel. Extent of disease was defined as the number of major coronalry arteries with significant occlusive disease. RESULTS: 1) Statistically significant risk factors between one vessel disease group and multivessel disease group are age, TC, LDL-C, and diabetes in total patients and age, LDL, and diabetes in male patients. But there is no significant difference in female patients. 2) In patients with multivessel disease, age, HDL-C level are significantly lowere, and TG level and the percentage of smkoing are significantly higher, in male than female. 3) There is increase in four major risk factors(diabetes, hypertension,smoking,hypercholesterolemia) with the increased number of diseasesd coronary arteries; normal coronary group has 1.07 risk factors, one vessel disease group 1.30, two vessel disease group 1.49, and three vessel disease group 1.78. 4) In total and male patients, three independent variables are significantly associated with severity of CAD. These variables are age, smoking, and diabetes. In female patients, diabetes in only significant independent risk factor. CONCLUSION: The significant independent risk factors associated with severity of CAD are age, diabetes, and smoking in total and male patients. Whereas in female patients, diabetes is only significant independent risk factor.

Pheochromocytoma with Unusual Electrocardiographic Changes and Having Clinical Features of Angina Pectoris : A Case Report

A 50 year old female presented unusual electrocardiographic changes including AV block, accelerated idioventricular rhythm, ventricular premature systole with severe fluctuation of blood pressure and clinical features of angina pectoris. Deep ST segment depression was demonstrated in spite of the normal coronary arteriogram and the negative coronary artery spasm study. Urinary excretion of catecholamines and their metabolites were elevated and a huge pheochromocytoma was found in the left adrenal glandd. After removal of the pheochromocytoma, the electrocardiographic abnormalities and the blood pressure were normalized and teh aptient became asymptomatic.