Risks of developing unstable angina in female smokers

The aim of the study: to determine the prevalence, interrelation and prognostic value of the major risk factors (RF) of unstable angina (UA) in women, depending on smoking habits. Materials and methods. 225 women (average age 53.80 ± 6.47 years) were examined: 150 women were patients with UA (gro...

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Main Authors: T. M. Solomenchuk, A. O. Bedzai, V. V. Protsko, V. L. Lutska
Format: Article
Language:English
Published: Zaporizhzhia State Medical and Pharmaceutical University 2020-08-01
Series:Zaporožskij Medicinskij Žurnal
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Online Access:http://zmj.zsmu.edu.ua/article/view/208350/211680
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author T. M. Solomenchuk
A. O. Bedzai
V. V. Protsko
V. L. Lutska
author_facet T. M. Solomenchuk
A. O. Bedzai
V. V. Protsko
V. L. Lutska
author_sort T. M. Solomenchuk
collection DOAJ
description The aim of the study: to determine the prevalence, interrelation and prognostic value of the major risk factors (RF) of unstable angina (UA) in women, depending on smoking habits. Materials and methods. 225 women (average age 53.80 ± 6.47 years) were examined: 150 women were patients with UA (group I) and 75 healthy women (group II). Depending on the smoking factor, all women were subdivided into subgroups: A (smokers, IA – patients with UA (n = 86), IIA – almost healthy (n = 45)) and B (non-smokers, IB – patients with UA (n = 64)), IIB were almost healthy (n = 30). The examination included an identification of major RF (hypertension, diabetes mellitus, obesity, dyslipidemia (DLP), measurement of total cholesterol, low-density lipoprotein cholesterol (LDL) and high density (HDL), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB), C-reactive protein (CRP), fibrinogen (FG), transforming growth factor (TGF-β2), endothelin-1 (ET-1), endothelial NO synthase (eNOS), malonic dialdehyde (MDA), ceruloplasmin (CP). In order to assess the impact of RF on the development of UA, a multifactorial correlation and regression analysis was performed using the Fisher test. Results. Female smokers (IA) were significantly 1.4–2.5 times more likely to have such RF as hypertension, diabetes mellitus, DLP and obesity than non-smokers (IB), as well as a combination of ≥3 RF (84.9 % vs. 62.5 %) and ≥5 RF (34.9 % vs. 13.9 %). Smoker patients showed severe disorders of lipid metabolism, higher activity of systemic inflammation and endothelial dysfunction. In female smokers (IA), the relative risk of developing UA was associated (P < 0.05) with DLP ((total cholesterol ˃4 mmol (OR = 12.02, CI = 8.12–16.32), LDL ˃1.8 mmol/l (OR = 9.32, CI = 6.13–12.56), HDL ˂1.2 mmol/l (OR = 3.91, CI = 2.12–5.45)), hypertension (OR = 3.49, CI = 2.96–4.25); endothelial dysfunction (ET-1 ˃7.87 pg/ml (OR = 7.44, CI = 2.89–6.21); eNOS ˂180 pg/ml (OR = 3.42, SI = 2.16–4.78); TGF-β2 <168 pg/ml (OR = 4.13; CI = 2.78–5.92)), systemic inflammation and peroxidation activity (CRP ˃3 mg/l (OR = 3.62, CI = 2.15–4.56), MDA ˃0.45 nmol/mg (OR = 2.89, CI = 1.55–3.91), CP ˃380 mg/year (OR = 2.34, CI = 1.46–3.25). Risks of UA development with regard to the above indicators was 1.5–2 times higher in female smokers (IA) compared to nonsmokers (IB), which might account for UA occurrence approximately 8 years earlier in female smokers (IA) than in non-smokers (IB). A strong multiple correlation was found between TGF-β2 and ET-1 (R = 0.60, at Р = 0.000003), as well as a high predicted risk of UA associated with ˃12 smoking years, ET-1 levels ˃30 pg/ml, TGF β2 ˂145 pg/ml, body mass index ˃30 units and CRP ˃14 mg/l. Conclusions. Smoking is one of the most aggressive factors of unstable angina in women, contributing to the appearance and progression of other major risk factors, which leads to systemic inflammation, peroxidation, endothelial dysfunction and increases the chances of acute coronary heart disease occurrence even in relatively young women.
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spelling doaj-art-603e94bea1d54f1f97d8ba13ca031c7f2025-08-20T02:35:21ZengZaporizhzhia State Medical and Pharmaceutical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102020-08-0122444645310.14739/2310-1210.2020.4.208350Risks of developing unstable angina in female smokersT. M. Solomenchuk0https://orcid.org/0000-0002-6153-0457A. O. Bedzai1https://orcid.org/0000-0002-5916-3715V. V. Protsko2https://orcid.org/0000-0001-7883-9306V. L. Lutska3https://orcid.org/0000-0003-1444-6399Danylo Halytsky Lviv National Medical University, Lviv, UkraineDanylo Halytsky Lviv National Medical University, Lviv, UkraineDanylo Halytsky Lviv National Medical University, Lviv, UkraineDanylo Halytsky Lviv National Medical University, Lviv, UkraineThe aim of the study: to determine the prevalence, interrelation and prognostic value of the major risk factors (RF) of unstable angina (UA) in women, depending on smoking habits. Materials and methods. 225 women (average age 53.80 ± 6.47 years) were examined: 150 women were patients with UA (group I) and 75 healthy women (group II). Depending on the smoking factor, all women were subdivided into subgroups: A (smokers, IA – patients with UA (n = 86), IIA – almost healthy (n = 45)) and B (non-smokers, IB – patients with UA (n = 64)), IIB were almost healthy (n = 30). The examination included an identification of major RF (hypertension, diabetes mellitus, obesity, dyslipidemia (DLP), measurement of total cholesterol, low-density lipoprotein cholesterol (LDL) and high density (HDL), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB), C-reactive protein (CRP), fibrinogen (FG), transforming growth factor (TGF-β2), endothelin-1 (ET-1), endothelial NO synthase (eNOS), malonic dialdehyde (MDA), ceruloplasmin (CP). In order to assess the impact of RF on the development of UA, a multifactorial correlation and regression analysis was performed using the Fisher test. Results. Female smokers (IA) were significantly 1.4–2.5 times more likely to have such RF as hypertension, diabetes mellitus, DLP and obesity than non-smokers (IB), as well as a combination of ≥3 RF (84.9 % vs. 62.5 %) and ≥5 RF (34.9 % vs. 13.9 %). Smoker patients showed severe disorders of lipid metabolism, higher activity of systemic inflammation and endothelial dysfunction. In female smokers (IA), the relative risk of developing UA was associated (P < 0.05) with DLP ((total cholesterol ˃4 mmol (OR = 12.02, CI = 8.12–16.32), LDL ˃1.8 mmol/l (OR = 9.32, CI = 6.13–12.56), HDL ˂1.2 mmol/l (OR = 3.91, CI = 2.12–5.45)), hypertension (OR = 3.49, CI = 2.96–4.25); endothelial dysfunction (ET-1 ˃7.87 pg/ml (OR = 7.44, CI = 2.89–6.21); eNOS ˂180 pg/ml (OR = 3.42, SI = 2.16–4.78); TGF-β2 <168 pg/ml (OR = 4.13; CI = 2.78–5.92)), systemic inflammation and peroxidation activity (CRP ˃3 mg/l (OR = 3.62, CI = 2.15–4.56), MDA ˃0.45 nmol/mg (OR = 2.89, CI = 1.55–3.91), CP ˃380 mg/year (OR = 2.34, CI = 1.46–3.25). Risks of UA development with regard to the above indicators was 1.5–2 times higher in female smokers (IA) compared to nonsmokers (IB), which might account for UA occurrence approximately 8 years earlier in female smokers (IA) than in non-smokers (IB). A strong multiple correlation was found between TGF-β2 and ET-1 (R = 0.60, at Р = 0.000003), as well as a high predicted risk of UA associated with ˃12 smoking years, ET-1 levels ˃30 pg/ml, TGF β2 ˂145 pg/ml, body mass index ˃30 units and CRP ˃14 mg/l. Conclusions. Smoking is one of the most aggressive factors of unstable angina in women, contributing to the appearance and progression of other major risk factors, which leads to systemic inflammation, peroxidation, endothelial dysfunction and increases the chances of acute coronary heart disease occurrence even in relatively young women.http://zmj.zsmu.edu.ua/article/view/208350/211680unstable anginawomensmokingrisk factors
spellingShingle T. M. Solomenchuk
A. O. Bedzai
V. V. Protsko
V. L. Lutska
Risks of developing unstable angina in female smokers
Zaporožskij Medicinskij Žurnal
unstable angina
women
smoking
risk factors
title Risks of developing unstable angina in female smokers
title_full Risks of developing unstable angina in female smokers
title_fullStr Risks of developing unstable angina in female smokers
title_full_unstemmed Risks of developing unstable angina in female smokers
title_short Risks of developing unstable angina in female smokers
title_sort risks of developing unstable angina in female smokers
topic unstable angina
women
smoking
risk factors
url http://zmj.zsmu.edu.ua/article/view/208350/211680
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AT vllutska risksofdevelopingunstableanginainfemalesmokers