Changes in risk factors in patients with and without acute coronary syndrome

This paper studied risk factors in patients with and without acute coronary syndrome who are undergoing percutaneous coronary intervention. The authors concluded that there were differences in risk factors between patients with or without acute coronary syndrome. 

In cardiovascular disease, blood vessels are blocked with plaque (a fatty substance, such as cholesterol), and blood cannot flow properly. This can lead to acute coronary syndrome, where blood supply to the heart is suddenly blocked. This syndrome includes chest pain and heart attack. Non-acute coronary syndrome (also known as stable angina) causes chest pain, especially during exercise. 

Percutaneous coronary intervention (PCI) is a procedure that can allow blood to flow better. Factors that may affect cardiovascular disease risk following PCI may differ between acute and non-acute coronary syndrome.

Data about patients who underwent percutaneous coronary intervention from 1994 to 2010 were analyzed. 58.3% of patients had acute coronary syndrome while 41.7% of patients did not have acute coronary syndrome. The average age of patients was 65 years. 10-year cardiovascular risk scores were calculated using the Framingham Risk Score, which includes age, diabetes, and cholesterol levels, among other factors.

The Framingham Risk Score and 10 year cardiovascular disease risk increased from 1994 to 1999, decreased from 2000-2006 and increased from 2006-2010. Overall, there was a trend towards decreasing risk. 10 year cardiovascular risk remained higher in patients with non-acute coronary syndrome than patients with acute coronary syndrome.

Blood pressure and good cholesterol levels were higher in patients with non-acute coronary syndrome. However, total cholesterol levels and bad cholesterol levels were higher in patients with acute coronary syndrome. Occurrence of high cholesterol levels, high blood pressure and diabetes increased over time, and were higher in patients with non-acute coronary syndrome. Prevalence of smoking increased over time in patients with acute coronary syndrome. Prevalence of smoking decreased over time in patients with non-acute coronary syndrome.

The use of medications increased over time.

Overall, changes in good cholesterol and blood pressure contributed to the improvement in the Framingham risk. 

The authors concluded that there are differences between patients with and without acute coronary syndromes which would give them different risks of heart disease.

Discuss with your doctor which risk factors you could improve on.