Risk stratification in stable angina pectoris

Abstract

Introduction. Stable angina pectoris has an impact on public health, which is explained by a large number of annually hospitalizations in the world. Risk stratification of patients is important to define prognosis, to guide medical management and to select patients suitable for revascularisation. Our objective is to study the particularities of risk factors in stratification in patients with stable angina pectoris. Materials and methods. The prospective study included 45 patients with stable angina pectoris hospitalized in Institute of Cardiology. The men: women ratio was 1.5:1, the mean age being 67,04±0,02 years. The assessment included the hystory, phyzical examination, electrocardiography (ECG) at rest, stress testing and echocardiography (Eco-CG). Acording Duke scale the patients were divided into 3 groups: I - 16 ( 35.56 % ) with low risk, II - 15 (33.33 % ) intermediate risk and III group - 14 ( 31.11 %) with high risk. Results. Analysis of the data noted men predominance in high-risk group - 9 (64.28%) cases, while the most of women - 9 (56.25%) were in-group with low risk. Analysis of cardiovascular risk factors detected prevalence of tobacco – 8 (57.14 %), sedentary – 12 (85.71%), obesity – 9 (64.28%) and dyslipidemia - 8 (57.14%) cases for the high risk and diabetes prevalent in those with intermediate risk - 13 (86.67%) cases. The distribution of functional class (FC) revealed that patients with FC III and IV prevails in high risk group with 5 (35.71%) patients in each. The radiation of the angina pain was more significant in high risk group – 10 (71.43%) cases comparing with 8 (53,33%) - in intermediate and 3 (18,75%) in low risk group. Improving pain at rest predominated in those with low risk - 12 (75 %) cases, while 10 (71.43%) with high risk cases needed administration of sublingual nitroglycerin. The ST segment deviation on ECG at rest was present in group II and III - in 13 (86.67%) and 11 ( 78.57%), respectively. Old myocardial infarction was identified also only in group II and III - 4 ( 26.67%) and 8 ( 57.14 %) cases. Left ventricular dysfunction was observed in 9 ( 64.28%) cases, only in those with high risk stratification. Conclusions. High risk stratification in stable angina is characterized by presents of traditional cardiovascular risk factors: tobacco - 8 (57.14%), sedentary - 12 (85.71%), obesity - 9 (64.28%) and with variety of clinical tools: radiation of the angina pain - 10 (71.43%), administration of sublingual nitroglycerin -10 (71.43%), ST segment deviation on ECG -11 (78.57%) and left ventricular dysfunction in 9 (64.28 %) cases.