Stable angina with intermedium coronary artery stenosis: the most typical clinical phenotypes

Aim of the study was to investigate the most typical phenotypes and to study cardiovascular risk factors and assess of the clinical angiographic picture in stable angina patients with intermedium coronary artery stenosis.

Material and methods. 236 stable angina functional class I–III patients (190 men) aged 49–59 with intermedium (40–70 %) coronary artery stenosis were examined. A general clinical examination, ultrasound examination and coronary angiography were performed. Study design – non-randomized descriptive study of four parallel groups. Differences in the compared parameters were considered statistically significant at p < 0.05.

Results. The prevailing phenotypes in stable angina patients with intermedium coronary artery stenosis turned out to be coronary artery disease (CAD) without a previous myocardial infarction (MI); CAD with previous MI less than a 6 months ago; CAD with metabolically unhealthy obesity phenotype (MUOP) without diabetes mellitus (DM), and CAD with DM type 2. Patients of different phenotypes did not significantly differ in the frequency of past MI. CAD and MUOP patients with previous MI were characterized by the earliest age of its occurrence. Despite the 100 % availability of hypertension in different phenotypes groups, in CAD and DM type 2 patients were largest left ventricle myocardium mass values. They also had the most frequently recorded multivessel lesion during the coronary angiography study. Despite ongoing outpatient treatment for one year, the values of lipid and inflammation indices (content of low-density cholesterol, triglyceride, C-reactive protein) were high in all phenotypes patients as well as number of people with insufficient blood pressure control.

Conclusions. In stable angina patients with intermedium coronary artery stenosis despite the absence of obstructive coronary artery lesion, the cardiovascular complications risk is due to the presence of 100 % arterial hypertension, high body mass index, significant frequency of obesity, dyslipidemia, carbohydrates metabolism disorders. That is why such patients represent a rather serious group in terms of prognosis. The clinical and angiographic picture, as well as residual risk levels, vary depending on the clinical phenotype.

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