[Atherosclerosis risk factors in patients examined by coronarography. I. Selection and evaluation of risk factors]. / Rizikové faktory aterosklerózy u koronargraficky vysetrených pacientu.I. Výber a hodnocení rizikových faktoru.

The significance of individual risk-factors associated with the ischaemic heart disease is known to be estimated differently in various stages. In this account, still more screening and evaluation of mentioned factors is continuously needed in facing different social, economical, demographical and geographical conditions. The analysis has been made of such risk-factors which are generally precluded as decisive ones (age, sex, blood lipid levels, cigarette smoking, higher blood pressure, obesity, diabetes mellitus). The majority of these factors and their interrelations may be influenced. Of special author's concern were different dependencies between the selective groups of coronarographied patients and the groups defined with mainly clinical symptomatology. Authors suggest that the analysis of proper group may be supportive in order to formulate such a complicated topic and outline the appropriate trends of secondary prevention also in their conditions.

[Atherosclerosis risk factors in patients examined by coronarography. II. Results and evaluation in the group of men]. / Rizikové faktory aterosklerozy u koronarograficky vysetrených pacientu. II. Výsledky a hodnocení souboru muzu.

The attherosclerosis risk-factors occurrence is studied in the present paper and compared with that of abnormal coronarogram in 376 male subjects. As an abnormal coronarogram is estimated this with at least one of coronaries having more than 50% of lumen obstructed. The abnormal coronarogram occurred significantly with more frequently in male patients with hyperlipoproteinemia an in smokers (p less than 0.001). In a total of male subjects with positive coronarographic findings, the significantly higher averaged levels of total cholesterol (p less than 0.01) have been stated. Authors detected the levels of total cholesterol higher than 6.72 mmol/l and those of triglycerides higher than 1.80 mmol/l are significantly exerting the influence on the value of coronarographic score. Of particular interest is a fact that no significant relation of abnormal coronarogram to the occurrence of systemic hypertension has been detected as well as to the disorders of glycide metabolism and obesity. However, mathematically significant relation has been determined between the smoking and hyperlipoproteinemia (p less than 0.001). The cigarette smoking was stated to enhance hyperlipoproteinemia as 4 %. Smokers have been found to represent pathologically increased both triglyceride and total cholesterol levels. It is to be said that the group of smokers has values of body mass index (BMI) lower ones than the group of non-smokers. Authors also revealed the disorders of glycide metabolism were related with higher occurrence of hyperlipoproteinemia in men as 1-2%. Although no significantly frequent occurrence of glycide metabolic disorders has been proved in men with abnormal coronarogram, the more detailed analysis showed those with glycide metabolic disorders were significantly higher in coronarographic score (p less than 0.05) in contrast with the group compared, and showed significantly higher occurrence of hemodynamically important stenoses than the controls. The results of the present work are believed to enlarge the knowledge about the relations between the atherosclerotic changes, their clinical manifestations and risk-factors estimated in conditions which are completely different from those of routine epidemiological studies. The necessity of primary prevention is confirmed and possible secondary measures are indicated.

[Atherosclerosis risk factors in patients examined by coronarography. III. Results and evaluation of the group of women]. / Rizikové faktory aterosklerózy u koronarograficky vysetrených pacientu. III. Výsledky a hodnocení souboru zen.

The occurrence of atherosclerosis risk-factors has been studied in comparison with the rate of abnormal coronarogram in 63 female subjects. As an abnormal coronarographic finding the obstruction of more than 50% lumen of at least one of coronaries was estimated. Female subjects with hyperlipoproteinemia (p less than 0.001) and hypertension (p less than 0.05) showed significantly more frequent abnormal coronarographic findings. Coronarographically positive women revealed significantly higher levels of total cholesterol (p less than 0.05). No relationship was detected between the pathological coronarogram and glycide metabolic disorders. Of particular interest is a fact that the disorders of glycide metabolism are conditioning the occurrence of hyperlipoproteinemia in women of our group as far as 15-16% (p less than 0.001), whereas in men only as 1-2 % (p less than 0.05). These results are supporting the opinion of those authors who point on the interaction between the disorders of glycide metabolism and hyperlipidemia estimating disorders of glycide metabolism in women to be more significant risk-factor of coronary atherosclerosis than in men. Our findings are confirming specificity of profile of atherosclerotic risk-factors in women. In accord with them, the importance of hyperlipidemia and hypertension is estimated to be the most significant risk of atherogenesis. The implementation of principles of primary and secondary prevention of ischemic heart disease is carried through the common approaches in both men and women.

[Atherosclerosis risk factors in patients examined by coronarography. IV. Relation of atherosclerosis risk factors and clinical manifestations of ischemic heart disease (myocardial infarct, angina pectoris)]. / Rizikové faktory aterosklerózy u koronarograficky vysetrených pacientu. IV. Vztah rizikových faktoru aterosklerózy a klinických projevu ischemické choroby srdecní [IM, AP].

The total of 376 male and 63 female subjects is concerned. As an abnormal coronarogram, such a finding is estimated where at least one of coronaries showed more than 50% lumen obstruction. The occurrence rates of atherosclerotic risk-factors, angina pectoris and myocardial infarction have been studied with regard to the abnormal coronarograms. A special concern in male group is almost simultaneous occurrence of angina pectoris along with positive coronarogram. The occurrence of both studied factors shows an increase with more age. The percentage of IM occurrence is practically the same in all age groups studied regardless to the value of coronarographic score. However, the male subjects with both clear and suspected IM (especially in the age group up to 40 years) are stated to show higher occurrence of normal coronarographic findings (32 %). This is in agreement with the suggestion that also other factors are involved than the atherosclerotic affection of coronary bed, what demonstrates the complexness of pathophysiological mechanisms of IM genesis.