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Dr. Adrian Man
Predictive value of risk factors, additional markers and efficacy of pharmacologic treatment in cardiovascular risk reduction in patients with coronary artery disease Elena Bobescu, Mariana Radoi, Georgeta Datcu, Zoltan Galajda, Antoniu Burducea, Carmen-Daniela Neculoiu, Roxana Bârsăşteanu, Dorina Popa, Valeria Paler, Delia Veştemean, Mirela Arsu, Mariana Anghel
Abstract: Aim: We analyzed the pharmacological treatment, risk factors and additional markers in patients with coronary artery disease – stable angina, unstable angina and non ST elevation myocardial infarction – in relation with the long-term prognosis. Design: 252 patients with high risk coronary artery disease, 150(59,2%) males, mean age 59,5 years, were evaluated for risk factors and additional markers (high titres of anti oxidated-LDL antibodies, low value of total antioxidant status, ST segment depression > 0.05 mV, ejection fraction < 40%) in relation with the occurrence of major acute cardiovascular events: unstable angina with readmission, ST elevation myocardial infarction, stroke, and cardiovascular death. Three groups were constituted: NSTEMI – 82 patients with non ST elevation acute myocardial infarction, UA – 90 patients with unstable angina, SA – 80 patients with stable angina. The follow-up period was 3 years. Results: In NSTEMI and UA groups, risk factors and additional markers with an important predictive value for major acute cardiovascular events, evaluated through cardiovascular risk (CVR) at 3 years of follow up, were: diabetes mellitus, C-reactive protein, troponin T, fibrinogen, cholesterol (total, HDL, LDL), CK-MB, total antioxidant status, anti oxidated-LDL antibodies, ST segment depression, kinetics abnormalities and low ejection fraction of the left ventricle (CVR = 2,11- 1,42). Therapeutic agents with the most efficacy in cardiovascular risk reduction in coronary artery disease patients were: simvastatin /atorvastatin, clopidogrel, metoprolol, trimetazidine, enalapril (CVR=0,39-0,64). Conclusions: Dosing the bio-humoral markers in acute coronarian syndromes is important for the diagnosis of acute myocardial infarction, for risk assessment in patients with myocardial infarction without ST elevation or with unstable angina and for establishing the target therapy in high-risk patients. Keywords: cardiovascular risk factors,predictive value,acute coronary syndrome |
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Bobescu E, Radoi M, Datcu G, Galajda Z, Burducea A, Neculoiu CD, et al. Predictive value of risk factors, additional markers and efficacy of pharmacologic treatment in cardiovascular risk reduction in patients with coronary artery disease. Rev Romana Med Lab. 2007;9(4):17-24
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