Risk Factors That Discriminate 'High-Risk' From 'Low-Risk' Japanese Patients With Coronary Artery Disease
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概要
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Although various risk factors have been implicated in the progression of coronary artery disease (CAD), coronary risk factors specifically related to the long-term prognosis for high-risk CAD have not been determined. The study enrolled 311 consecutive Japanese patients with CAD who underwent diagnostic coronary arteriography an divided them into 2 groups: (i) 135 high-risk patients with either impaired left ventricular function (ejection fraction <50%) or multivessel disease and (ii) 176 low-risk patients with normal left ventricular function and 0- or 1-vessel disease. The prevalence of risk factors including age, gender, smoking, hypertension, diabetes mellitus (DM), obesity and lipid variables were compared between the 2 groups. The prevalence of DM, a serum high-density lipoprotein (HDL)-cholesterol level below 35mg/dl and a serum lipoprotein (Lp) (a) level above 25 mg/dl was significantly higher in the high-risk group as compared with the low-risk group. Multiple logistic regression analysis demonstrated that DM (odds ratio (OR): 1.72, 95% confidence intervals (CI): 1.02-2.92, p<0.05), a low HDL-cholesterol level (OR: 2.49, 95% CI: 1.49-4.17, p<0.001) and a high Lp(a) level (OR: 1.68, 95% CI: 1,02-2.76, p<0.05) were all independent risk factors for high-risk CAD. However, if the patients with 0-vessel disease were excluded from the low-risk group, a low HDL-cholesterol level was found to be the only independent predictor for high-risk CAD (OR: 2.07, 95% CI: 1.15-3.70, p<0.05). Among both men and smokers in this population, a higher Lp(a) level was found to be a significant predictor for high-risk CAD. A low serum level of HDL-cholesterol, a high serum level of Lp(a) and DM were significant predictors of high-risk in patients with CAD. Among patients with a significant coronary stenosis or left ventricular dysfunction, a low serum level of HDL-cholesterol was the only significant predictor for high-risk CAD.
- 社団法人日本循環器学会の論文
- 2000-10-20
著者
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Miwa Kunihisa
The Second Department of Internal Medicine, Kansai Electric Power Hospital
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Nakagawa Keiko
The Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University
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Miwa Kunihisa
The Second Department Of Internal Medicine Kansai Electric Power Hospital
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Nakagawa Keiko
The Second Department Of Internal Medicine Toyama Medical And Pharmaceutical University
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