Revista Colombiana de Cardiología (Dec 2008)
El sobrepeso es el factor determinante en la presentación de síndrome coronario agudo en adultos jóvenes colombianos Overweight is a determinant factor in the presentation of acute coronary syndrome in colombian young adults
Abstract
Antecedentes: la obesidad es un factor de riesgo para un primer infarto agudo del miocardio. La enfermedad coronaria prematura genera gran impacto socioeconómico por los años productivos perdidos, lo que hace importante su prevención y tratamiento. Objetivo: evaluar el impacto de la obesidad y otros factores de riesgo convencionales en la presentación de un primer evento coronario agudo en sujetos menores de 50 años. Métodos: estudio transversal que incluyó pacientes con diagnóstico de síndrome coronario agudo que ingresaron a la institución entre febrero de 2002 y febrero de 2007. La población se dividió en: sujetos menores y mayores de 50 años, estos últimos seleccionados de manera aleatoria en relación 1:1. La información demográfica, la historia cardiovascular y los factores de riesgo se identificaron en la historia clínica electrónica de la institución y y se corroboraron por vía telefónica. Se empleó la prueba t de student o Wilcoxon rank-sum, según la distribución de las variables. Se realizó un análisis multivariado para determinar los factores de riesgo independientes. Un valor de p Background: obesity is a risk factor for developing a first myocardial infarct. Premature coronary disease generates a big socioeconomical impact due to productive years loss, which makes important its prevention and treatment. Objective: evaluate the impact of obesity and other conventional risk factors in the presentation of a first acute coronary event in subjects < 50 years. Methods: transversal study that included patients with diagnosis of acute coronary syndrome admitted to the institution between February 2002 and February 2007. The population was divided in subjects younger and older than 50 years, these last ones selected at random in a 1:1 relation. Demographic information, cardiovascular history and risk factors were identified in the institution’s electronic clinical history and were corroborated by telephone. The t student or Wilcoxon rank-sum test was used, according to the variables distribution. A multivariated study for determining the independent risk factors was performed. A p < 0,05 value was considered significant. Results: during the study period 942 subjects with acute coronary syndrome diagnosis were admitted. 16.1% (152) were subjects younger than 50 years and 90.79% (132) had a first event. Mean age in the young group was 44.3 ± 5,1 and in the older group (n = 132) was 65,6 ± 8,3 years. Overweight (OR 1.095; IC 1,01-1,18 p=0,019) and leucocyte count (OR 1,00; IC 1.001-1.005 p=0,001) were the two independent factors that predicted acute coronary syndrome in younger than 50 years adults, after realizing a multivariate non conditional analysis. Other conventional risk factors did not show significant difference. Conclusion: overweight and inflammation estimated by leucocyte count were the independent risk factors for the presentation of a first episode of acute coronary syndrome in Colombian adults younger than 50 years. These results confirm the importance of overweight and inflammation in the physiopathological mechanisms of cardiovascular disease in our population.
