Risk factors for atherosclerosis - can they be used to identify the patient with multisystem atherosclerosis?
Risk factors are often used in preventive care programmes to identify the patient at particular risk for developing atherosclerosis. Risk factors for atherosclerosis have also been shown to be linked to the presence of the disease at a given time, a fact that may be helpful when screening for additional atherosclerotic disease in the known arteriopath. Risk factors .were recorded in 471 patients admi"ed to hospital with symptoms of atherosclerosis. In patients admi"ed primarily with peripheral vascular disease, risk factors linked to the presence of additional coronary artery disease were a family history of ischaemic heart disease (odds ratio = 2,6), the presence of carotid artery disease (odds ratio = 1,9) and high fasting serum triglyceride levels (P < 0,04). Grouping these factors together usin.g logistic regression, ischaemic heart disease could be predicted with a sensitivity of 72% and a specificity of 43%. Patients admitted with carotid artery disease were more likely to have ischaemic heart disease in the presence of peripheral vascular disease (odds ratio = 1,9) and a raised serum cholesterol level (P < 0,02), while female gender (odds ratio = 2,9) and an increase in age (P< 0,001) were linked to an increased prevalence of concomitant atherosclerosis in patients admmed with acute myocardial infarction or for elective coronary artery bypass surgery. Using an age cut-off point, additional atherosclerosis could be predicted with a sensitivity of 32% and a specificity of 88% in these patients.