engleski

CLINICAL ASSESSMENT OF CORONARY ARTERY DISEASE SEVERITY: THE ROLE OF ARTERIAL HYPERTENSION

Objective Arterial chronic hypertension (HTN) is one of the main risk factor leading to atherogenesis and the development of coronary vulnerable plaques whose instability or rupture are responsible for the development of acute coronary syndromes (ACS). In the general population, the prevalence of hypertension rises progressively with age in both men and women, while in patients with acute myocardial infarction (MI) the prevalence of antecedent hypertension varies from 31 to 59%. Pathophysiological role of HTN in the pathophysiology of ACS-with and without ST segment elevation is different. Design and Methods The research involved 33 adult examinees (20 men, 13 women) that were hospitalized in the Department for heart and blood vessel diseases of the University Hospital Centre Osijek because of ACS without ST elevation. Excluded criteria were heart failure, neurologic incident, septic condition, renal insufficiency, and anemia. All examinees were monitored for changeable and non- changeable conventional risk factors for coronary artery disease (CAD) and electrocardiogram (ECG) changes. They also underwent laboratory analyses, echocardiographic measurements and coronarography. Results Average age of male was 57±13 and female 67±10 years. 28 examinees were hypertensive (84%, 17 men/11 women). In hypertensive groups, 47% men were smokers and none single woman, while 28% men and 66% woman were diabetics. ST depression was the most frequent in woman (72%), while ST depression and negative T wave in men occurred equally (35%). In both genders hypertensive subjects the most common was single-vessel CAD. Correlation of triple-vessel CAD and maximum value of troponin was statistically significant. Conclusion For the purpose of early detection and appropriate treatment of high-risk patients without ST elevation, it is necessary to take into account all risk factors (age, gender and co-morbidities) and ECG changes.

coronary artery disease ; arterial hypertension

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