DR. SHARIATI HOSPITAL, NORTH KARGAR AVE. TEHRAN, IRAN
Background – The Framingham study on the heart is one of the first and largest studies on the identification of risk factors for coronary artery disease (CAD). The American Heart Association (AHA) has planned a standard table to predict the risk of CAD based on this study. The risk factors used in this study included age, total cholesterol, HDL-C, systolic heart pressure, cigarette smoking, diabetes and left ventricular hypertrophy based on ECG.
We used this table to evaluate the risk of CAD in type II diabetic patients in a cross-sectional study in a diabetes clinic in Tehran.
Methods - The patients were divided into four groups according to the evaluated risk. As in the evaluation of the risk of other risk factors like obesity (WHR, BMI), triglycerides, LDL-C and DBP were studied and their relation to the rate of the risk was calculated by statistical tests like linear regression, ANOVA one-way in SPSS.V6 software.
Results - The increase of the ten-year risk was obvious among the studied patients, consisting of 91 women and 48 men. The rates of the five-year and ten-year risk in men were much higher than those in women. The risk factors studied in all the patients had a high rate. For example in 36.4% of the patients the rate of HDL-C was ≤35 mg/dl. The proportion of total cholesterol to HDL-C, which is an important risk factor for CAD, was 6.18±1.76 for men and 5.97±2.12 for women. There was no meaningful relation between the 10-year and 2-year risk with WHR, BMI and TG, but a meaningful relation was found between 5-year and 2-year risk with DBP (p=0.0006 and p=0.0001) and LDL-C (p=0.006 and p=0.001).
Conclusion - Although the risk of CAD in diabetic patients is shown in this study, it seems that the real risk is more than that. On the other hand, the lack of a meaningful relation between WHR, BMI, TG and CAD risk can lower the value of this table. So, more detailed studies are needed for the future