Risk Factors in Coronary Artery Disease PDF

Preface

Coronary artery disease (CAD), resulting from atherosclerosis and thrombosis (atherothrombosis), is the leading cause of death and morbidity in much of the industrialized world and is rapidly achieving the same dubious distinction in developing nations as well. In the cardiovascular field, prevention of CAD and its effective treatment remain paramount objectives of clinical practice as well as targets of ongoing research. The precise etiology and mechanism(s) leading to the development of CAD remain incompletely understood although a number of risk factors have been identified over the past several decades. These include abnormal levels of circulating cholesterol with elevated levels of LDL and reduced levels of HDL cholesterol, hypertension, cigarette smoking, diabetes, male gender, postmenopausal state, advancing age, sedentary lifestyle, obesity, and a positive family history of premature vascular disease. Increasing recognition that many patients (as many as 30–50%) with established CAD lack these traditional risk factors has led to a search for additional new risk factors that may predispose individuals to CAD. Over the past several years, observational and epidemiologic studies have identified a host of new and potential risk factors for atherothrombotic vascular disease. Of this growing list of new and emerging risk factors, elevated blood levels of homocysteine, fibrinogen, inflammation and infection, atherogenic lipoprotein phenotype associated with small LDL cholesterol particles and elevated triglycerides, elevated levels of lipoprotein(a) (Lpa), insulin resistance syndrome (syndrome X or Reaven's syndrome or deadly quartet), psychosocial factors and a number of genetic polymorphisms are of particular interest. The goal of this monograph is to bring to our readers the latest update on these new and emerging risk factors that could open up new opportunities for diagnosis, risk prediction, prevention, and treatment of atherothrombotic vascular disease.