Ali Rafighdoust Abbas, Asadollah Mirzaee, Hossien Rafigdoust Amir
Cardiology department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Cardiac surgery department, Ghaeem hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Cardiol Res. 2010 Dec;1(1):15-19. doi: 10.4021/cr103e. Epub 2010 Nov 20.
Atherosclerosis of coronary arteries is the most common cause of myocardial infarction (MI), which is initiated from childhood and progresses gradually by aging. Several risk factors influence its progress, and are categorized as classic, traditional and novel factors. The role of unknown risk factors is becoming increasingly more significant recently. The aim of this study is to underscore the novel risk factors despite the importance of classic factors and consider these factors for future studies.
This is a prospective study on 180 myocardial infarction cases, conducted in the cardiology ward and CCU of Imam-Reza hospital (Mashad-IRAN). A number of risk factors identified and evaluated in these patients included: hyperlipidemia, hypertension, diabetes, smoking, activity, stress, hair of external ear canal and ear lobe crease, age, and sex. Then patients without any risk factor or with one or two risk factors were distinguished.
The majority of our patients were old men in the age range of 60 - 69 years. Amongst all patients 42.2% were smokers, 68.3% were type A personality group, 19% were active, 81% were physically inactive, 37.2% had hairy ear canal, 35% had hypertension, 21.1% were diabetic, 14.4% had hyperlipidemia and 30% had positive family history of myocardial infarction. Of great interest was the fact that of the patients whose case was studied, many did not have any risk factor or in some cases had only one.
In regard of increasing rate of cardiovascular diseases and myocardial infarction even amongst the young population, and because of considerable need to improve vascular risk detection, much research over the past decade has focused on identification of novel atherosclerotic risk factors, and some of these new risk factors are identified and some may be unknown. Amongst the new risk factors, inflammation has an important role, other risk factors that must be assessed are homocysteine, serum amyloid, and antibodies against Oxidized LDL. So we recommend that governments and heart associations must introduce new plans and policies in order to tackle the problem and reduce the frequency of cardiovascular disease. This requires the understanding of the conventional or classic risk factors and also the less known and new risk factors and ways which they may be prevented.
冠状动脉粥样硬化是心肌梗死（MI）最常见的病因，其始于儿童期，并随年龄增长逐渐发展。多种危险因素影响其进展，这些因素可分为经典因素、传统因素和新型因素。近年来，未知危险因素的作用日益显著。本研究的目的是强调新型危险因素的重要性，尽管经典因素也很重要，并为未来研究考虑这些因素。
这是一项对180例心肌梗死患者进行的前瞻性研究，在伊玛目·礼萨医院（伊朗马什哈德）的心脏病病房和冠心病监护病房开展。在这些患者中确定并评估的一些危险因素包括：高脂血症、高血压、糖尿病、吸烟、活动情况、压力、外耳道毛发和耳垂皱褶、年龄及性别。然后区分出无任何危险因素或有一两个危险因素的患者。
我们的大多数患者为60 - 69岁的老年男性。在所有患者中，42.2%为吸烟者，68.3%为A型性格人群，19%活动量正常，81%身体不活动，37.2%有外耳道多毛，35%患有高血压，21.1%患有糖尿病，14.4%患有高脂血症，30%有心肌梗死家族史阳性。有趣的是，在研究的患者中，许多人没有任何危险因素，或在某些情况下仅有一个危险因素。
鉴于心血管疾病和心肌梗死的发病率不断上升，甚至在年轻人群中也是如此，而且由于迫切需要改善血管风险检测，过去十年的许多研究都集中在识别新型动脉粥样硬化危险因素，其中一些新危险因素已被识别，还有一些可能未知。在新危险因素中，炎症起着重要作用，其他必须评估的危险因素包括同型半胱氨酸、血清淀粉样蛋白以及抗氧化低密度脂蛋白抗体。因此，我们建议政府和心脏协会必须出台新的计划和政策，以解决这一问题并降低心血管疾病的发生率。这需要了解传统或经典危险因素以及鲜为人知的新危险因素，以及预防这些危险因素的方法。
