Русский
Value of cardiovascular risk factors in pre-test assessment of coronary heart disease
DOI: https://dx.doi.org/10.18565/therapy.2023.1.70-77
Roytberg G.E., Slastnikova I.D., Sharkhun O.O., Davydova A.S.
N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
The aim of the study was to analyze the RFs for CVD in patients with various PTPs for CHD.
Material and methods. The study included 141 patients (81 males and 60 females) aged 40–75 years old (medium age 62,6±8,3 years) with suspected CHD. All participants underwent PTP calculation, standard physical examination and laboratory examination, and the presence of CVD RFs was analyzed. According to PTP results, 2 groups were formed: with low (<15%) and intermediate (≥15%) PTP. MSCT coronary angiography was performed to assess the lesion of the CA, the calcium index (CI) was calculated using the Agatston scale.
Results. Among patients with low PTP (n=84), the presence of 0–1 RF was observed in 36,9% of patients with non-obstructive coronary stenosis (1st subgroup) and only in 5,3% of patients with stenosis ≥50% (2nd subgroup). In the 2nd subgroup, the presence of 3–4 risk factors was found in 52,6% of patients, while in the 1st subgroup it was only in 21,5% (p=0,01). In this group, CI <100 was found in 84,6% of patients of the 1st subgroup, the opposite picture was obtained among patients of the 2nd subgroup: CI >100 was detected in 89,5% of patients. In the 2nd group with intermediate PTT (n=57), there was a predominance of 3–4 RFs in patients with CA stenosis ≥50% compared with persons without significant stenosis (45,8% and 18,2%, respectively, p=0,03). Extremely high CI (≥400) was observed in 58,3% of patients with obstructive stenosis, while 72,8% of patients with stenosis <50% did not have significant coronary calcification (including 36,4% of people had CI=0).
Conclusion. Patients with low PTP of CHD and one RF, as a rule, do not have obstructive CA stenosis, and in the presence of 3–4 RF, significant coronary stenosis are much more common. CI ≥100 may serve as an indication for further examination of the patient with a low probability of CHD, and CI <100 is associated with the absence of obstructive coronary stenosis in both low and intermediate PTP of CHD.
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About the Autors
Grigory E. Roytberg, MD, professor, academician of RAS, head of the Department of therapy, general medical practice and nuclear medicine of the Faculty of additional professional education, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 125047, Moscow, 10 2nd Tverskoy-Yamskoy Lane. E-mail: contact@medicina.ru. ORCID: https://orcid.org/0000-0003-0514-9114
Irina D. Slastnikova, PhD in Medicinal Sciences, associate professor of the Department of therapy, general medical practice and nuclear medicine of the Faculty of additional professional education, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 125047, Moscow, 10 2nd Tverskoy-Yamskoy Lane. E-mail: slastid@mail.ru. ORCID: https://orcid.org/0000-0002-4076-2849
Olga O. Sharkhun, MD, associate professor, professor of the Department of therapy, general medical practice and nuclear medicine of the Faculty of additional professional education, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 125047, Moscow, 10 2nd Tverskoy-Yamskoy Lane. E-mail: olga_sharkhun@mail.ru. ORCID: https://orcid.org/0000-0001-8527-4681
Alina Sh. Davydova, postgraduate student of the Department of therapy, general medical practice and nuclear medicine of the Faculty of additional professional education, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 125047, Moscow, 10 2nd Tverskoy-Yamskoy Lane. E-mail: alina.tsyganova@gmail.com. ORCID: https://orcid.org/0000-0002-5738-0740
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