Factors affecting the progression of atherosclerosis in the coronary arteries.

BACKGROUND

The induction and progression of atherosclerotic changes is complex and influenced by many factors. The most important are enhanced concentration of LDL cholesterol, enlarged production of free radicals, the inflammatory reaction, endothelial damage, decreased concentration of HDL and increased prothrombotic activity.

AIM

To define the factors influencing the atherosclerotic process in the coronary arteries of patients with coronary disease in serial coronary examinations.

METHODS

In the 2nd Department of Cardiology in the Medical University of Lodz, 8989 coronary angiography studies were performed between January 1999 and May 2004. The second intervention in the earlier studied patients was made because of clinical indications. The investigation included 177 consecutive patients (128 men and 49 women) in whom the coronary angiography was executed at least twice.

RESULTS

A significantly larger degree of atherosclerotic process occurred in the group of patients younger than the average age of the studied group (p=0.004), in those with a family history of circulatory diseases (p=0.02), as well as in patients with numerous risk factors of coronary disease (p=0.01). In the well-fitted model of the prediction of progression of vascular changes, according to the Gensini Score in individual time (p <0.02), two independent parameters were identified - gender (p=0.04) and statin therapy (p=0.03). The odds ratio with 95% confidence interval in males was 2.1 (1.1-5.2), and for the use of statin - 0.48 (0.21-0.91).

CONCLUSIONS

Significant progression of atherosclerotic changes in the coronary vessels was confirmed in the studied population. In the group of men faster progression of atherosclerotic changes, in particular of lesions in the proximal parts of the coronary arteries, was confirmed, whereas therapy with statins significantly slowed down this process in all studied sections of the coronary arteries, especially in their distal parts.