High-density lipoprotein cholesterol level and smoking modify the prognosis of patients with coronary vasospasm
| Autor: | Kunihisa Miwa, Masatoshi Fujita, Shigetake Sasayama, Yuko Miyagi, Hiroshi Inoue |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Male
medicine.medical_specialty Lipoproteins Myocardial Infarction Coronary Vasospasm Group A Gastroenterology Group B Coronary artery disease chemistry.chemical_compound Risk Factors Internal medicine medicine Humans Myocardial infarction Angina Unstable Stroke Triglyceride Unstable angina business.industry Incidence Smoking General Medicine Middle Aged medicine.disease Prognosis Lipoproteins LDL Cerebrovascular Disorders Endocrinology chemistry Coronary vasospasm Female Cardiology and Cardiovascular Medicine business Lipoproteins HDL |
| Zdroj: | Clinical cardiology. 18(5) |
| ISSN: | 0160-9289 |
| Popis: | A cardiovascular event analysis was performed in a subset of 80 consecutive patients with vasospastic coronary artery disease. During the follow-up period (30 ± 2 months, mean ± SD), 9 patients had vascular accidents, including acute myocardial infarction, unstable angina, and stroke (Group A), while the remaining 71 patients were eventfree (Group B). Serum total-cholesterol, low-density lipoprotein cholesterol, and triglyceride levels were not different between the two groups at the baseline as well as after follow-up. However, the HDL-C level at baseline was significantly lower in Group A (33.5 ± 2.6 mg/dl) than in Group B (41.9 ± 1.7 mg/dl, p < 0.05). The HDL-C level increased significantly during the follow-up in Group B (ΔHDL-C: 6.2 ± 1.2 mg/dl, p < 0.01), but not in Group A (ΔHDL-C: - 3.2 ± 2.7 mg/dl). The HDL-C level after follow-up was significantly lower in Group A (30.3 ± 2.9 mg/dl) than in Group B (48.1 ± 1.5 mg/dl, p < 0.01). Current smokers at the end of the follow-up period were more prevalent in Group A (67%) than in Group B (11%, p < 0.01). Cardiovascular accidents occurred more often in current smokers (6/14, 43%) at the end of the followup than in current nonsmokers, including quitters (3/66, 5%; p < 0.05). The HDL-C level was increased significantly (ΔHDL: 6.2 ± 1.3 mg/dl, p < 0.01) in the latter patients, but not in the former (ΔHDL: –0.4 ± 2.9 mg/dl). Cardiovascular accidents were significantly (p < 0.01) more common in patients with lower (< 40 mg/dl) HDL-C levels (7/23, 30%) than in those with higher HDL-C levels (2/57, 4%) after followup, although this difference was not significant when patients were divided according to these levels at baseline. These results indicated that a low HDL-C level after follow-up is more predictive of subsequent cardiovascular events than at baseline. The increase in HDL-C level attained by smoking cessation appears important for a favorable prognosis. |
| Databáze: | OpenAIRE |
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