title: Parallel comparison of risk factors between progression of organic stenosis in the coronary arteries and onset of acute coronary syndrome by covariance structure analysis.
abstract: BACKGROUND
  It is widely accepted that progression of organic stenosis in the coronary arteries and onset of acute coronary syndrome (ACS) are similar in the development of atherosclerosis. However, the extent of the association of each risk factor with the respective pathological conditions has not been fully elucidated.
  
  
  OBJECTIVE
  We investigated the differences in risk factors between these conditions using a statistical procedure.
  
  
  METHODS
  The study population consisted of 1,029 patients with ischemic heart disease (IHD). We divided the study population into two groups (ACS and non-ACS) and by diseased vessels (organic stenosis). Covariance structure analysis was simultaneously performed in one equation model for determination and comparison of the risk factors for organic stenosis and ACS.
  
  
  RESULTS
  The analysis revealed that age (standardized regression coefficient, β: 0.206, P < 0.001), male gender (β: 0.126, P < 0.001), HbA1c level (β: 0.109, P < 0.001), HDL level (β: -0.109, P < 0.001) and LDL level (β: 0.127, P = 0.002) were significant for the advancement of organic stenosis. HDL level (β: 0100, P = 0.002) and MDA-LDL level (β: 0.335, P < 0.001) were significant for the onset of ACS, but age, HbA1c and LDL (P = NS or β < 0.1, respectively) were not. Among the risk factors, age, HbA1c and LDL were significantly more strongly associated with organic stenosis than ACS, while MDA-LDL was significantly more strongly associated with ACS than organic stenosis.
  
  
  CONCLUSIONS
  The current statistical analysis revealed clear differences among the risk factors between the progression of organic stenosis and the onset of ACS. Among them, the MDA-LDL level should be considered to indicate a substantial risk of ACS.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, the Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Division of Cardiology, Department of Internal Medicine, the Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Minai
authors.affiliation: Division of Cardiology, Department of Internal Medicine, the Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawai
authors.affiliation: Division of Cardiology, Department of Internal Medicine, the Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Division of Cardiology, Department of Internal Medicine, the Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Nagoshi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, the Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ogawa
authors.affiliation: Division of Cardiology, Department of Internal Medicine, the Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology*; D000368:Aged; D023921:Coronary Stenosis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors