Association of cardiovascular risk factors with the different presentations of acute coronary syndrome

Brunori, Evelise Helena Fadini Reis; Lopes, Camila Takáo; Cavalcante, Agueda Maria Ruiz Zimmer; Santos, Vinicius Batista; Lopes, Juliana de Lima; Barros, Alba Lucia Bottura Leite de

doi:10.1590/0104-1169.3389.2449

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 22 (4) • Jul-Aug 2014 • https://doi.org/10.1590/0104-1169.3389.2449 copy

Association of cardiovascular risk factors with the different presentations of acute coronary syndrome¹ 1 Paper extracted from master's thesis "Sociodemographic and clinical characteristics and cardiovascular risk factors in individuals hospitalized for acute coronary syndrome", presented to Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil. Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, process # 301688/2009-5

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to identify the relationship between different presentations of acute coronary syndrome and cardiovascular risk factors among hospitalized individuals.

METHOD:

cross-sectional study performed in a teaching hospital in São Paulo, in the State of São Paulo (SP). Socio-demographic, clinical and anthropometric data of 150 individuals hospitalized due to acute coronary syndrome were collected through interviews and review of clinical charts. Association between these data and the presentation of the syndrome were investigated.

RESULTS:

there was a predominance of ST segment elevation acute myocardial infarction. There was significant association of systemic hypertension with unstable angina and high values of low density lipoprotein with infarction, without influence from socio-demographic characteristics.

CONCLUSION:

arterial hypertension and high levels of low-density lipoprotein were associated with different presentations of coronary syndrome. The results can provide support for health professionals for secondary prevention programs aimed at behavioural changing.

Acute Coronary Syndrome; Risk Factors; Myocardial Infarction; Angina Pectoris

Variable		Medical diagnosis			Total (n=150)	p
Variable		UA* (n=22)	NSTEMI^† (n=19)	STEMI^‡ (n=109)	Total (n=150)	p
Age (years)						0.184^§
	Mean	58.41	61.63	56.61	57.51
	Standard deviation	10.71	13.41	10.85	11.23
Sex (%)						0.088^\|\|
	Female	45.5	31.6	22.9	27.3
	Male	54.5	68.4	77.1	72.7
Color (%)						0.943^\|\|
	Black	36.4	31.6	30.3	31.3
	White	0	0	1.8	1.3
	Asian	63.6	68.4	67.9	67.3
Religion						0.765^¶
	Roman Catholic	59.1	84.2	73.4	72.7
	Evangelical	22.7	10.5	11.9	13.3
	Spiritualist	4.5	0	3.7	3.3
	Others	4.5	0	5.5	4.7
	None	9.1	5.3	5.5	6.0
Educational level (%)						0.619^¶
	Incomplete Primary education	31.8	47.4	34.9	36.0
	Complete Primary education	40.9	42.1	33.0	35.3
	Incomplete Secondary education	0	5.3	7.3	6.0
	Complete Secondary education	22.7	0	17.4	16.0
	Incomplete Higher education	0	0	2.8	2.0
	Complete Higher education	4.5	5.3	3.7	4.0
	Post-graduate	0	0	0.9	0.7
Marital status/Family situation (%)						0.518^¶
	Single	13.6	10.5	8.3	9.3
	Married	54.5	47.4	65.1	61.3
	Divorced	13.6	21.1	14.7	15.3
	Widowed	18.2	15.8	7.3	10.0
	Lives with partner	0	5.3	4.6	4.0
Income (minimum salaries)						0.467^¶
	1	9.1	15.8	11.0	11.3
	2	50.0	57.9	44.0	46.7
	3	22.7	5.3	26.6	23.3
	4	18.2	10.5	12.8	13.3
	6	0	10.5	5.5	5.3

		Medical diagnosis								p^§
		UA* (n=22)		NSTEMI^† (n=19)		STEMI^‡ (n=109)		Total (n=150)
		n	%	N	%	n	%	n	%
Comorbidity
	Arterial hypertension	21	95.5	15	78.9	64	58.7	100	66.7	0.002
	Dyslipidemia	13	59.1	6	31.6	41	37.6	60	40.0	0.125
	Diabetes mellitus	6	27.3	7	36.8	30	27.5	43	28.7	0.701
Family antecedent
	Arterial hypertension	14	63.6	13	68.4	79	72.5	106	70.7	0.690
	Coronary artery disease	12	54.5	10	52.6	69	63.3	91	60.7	0.555
	Dyslipidemia	9	40.9	4	21.1	32	29.4	45	30.0	0.369
	Diabetes mellitus	9	40.9	7	36.8	46	42.2	62	41.3	0.908

		Medical diagnosis								p
		UA* (n=22)		NSTEMI^† (n=19)		STEMI^‡ (n=109)		Total (n=150)
		n	%	n	%	n	%	n	%
Number of arteries
	One artery	4	18.2	11	57.9	38	34.9	53	35.3	0.029^§
	Two arteries	10	45.5	3	15.8	38	34.9	51	34.0	0.127^§
	Three arteries	8	36.4	5	26.3	30	27.5	43	28.7	0.684^§
	Trunk of left coronary artery	2	9.1	0	0	1	0.9	3	2.0	0.097^\|\|
Treatment
	Clinical	12	54.5	7	36.8	1	0.9	20	13.3	<0.001^\|\|
	Percutaneous coronary intervention – anterior descending artery	3	13.6	5	26.3	57	52.3	65	43.3	0.001^§
	Percutaneous coronary intervention – circumflex artery	0	0	2	10.5	14	12.8	16	10.7	0.219^\|\|
	Percutaneous coronary intervention – right coronary artery	0	0	1	5.3	23	21.1	24	16.0	0.011^\|\|
	Percutaneous coronary intervention – trunk of left coronary artery	0	0	0	0	1	0.9	1	0.7	1.000^\|\|
	Myocardial revascularization surgery	7	31.8	4	21.1	18	16.5	19	19.3	0.223^\|\|

Parameter	Medical diagnosis (mean ± standard deviation)				p
Parameter	UA* (n=22)	NSTEMI^† (n=19)	STEMI^‡ (n=109)	Total (n=150)	p
Blood glucose (mg/dL)	142.5±59.54	141.84±95.38	145.39±67.09	144.5±69.81	0.149^§
Total cholesterol (mg/dL)	173.16±59.61	198.75±39.7	202.58±56.27	198.21±55.68	0.105^\|\|
High Density Lipoprotein – HDL (mg/dL)	38.21±12.07	38.69±9.92	40.99±11.72	40.36±11.56	0.523^\|\|
Low density lipoprotein – LDL (mg/dL)	92.22±48.67	130.38±38.09	127.98±46.3	123.69±47.04	0.009^\|\|
Triglycerides (mg/dL)	196.58±124.87	150.56±87.19	148.19±77.14	154.93±86.85	0.274^§
Body Mass Index – BMI (kg/m²)	28.23±4.65	25.68±3.39	26.83±4.39	26.89±4.34	0.122^§
Waist-hip ratio	0.98±0.14	0.96±0.09	0.99±0.09	0.98±0.1	0.263^§

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[1] Corresponding Author: Alba Lucia Bottura Leite de Barros Universidade Federal de São Paulo. Escola Paulista de Enfermagem Rua Napoleão de Barros, 754 Vila Clementino CEP: 04024-002, São Paulo, SP, Brasil E-mail: barros.alba@unifesp.br