Abstract 15840: Comparison of Risk Factors for Single, Double, and Multivessel Coronary Artery Disease in a Cohort Undergoing Coronary Revascularization

Introduction: Hypertension (HTN), dyslipidemia (HLD), smoking, obesity, and diabetes (DM), peripheral arterial disease (PAD) are known risk factors for coronary artery disease (CAD). However, it is not clear if one risk factor is related to causing higher plaque burden than others. We attempted to find relationship of these risk factors with number of occluded coronary arteries (>50% stenosis) to assess plaque burden.

Methods: Retrospective analysis of patients admitted to a tertiary care center undergoing coronary revascularization (PCI or CABG) for acute myocardial infarction (AMI) from May 2019 - May 2021. Patients were classified based on the number of occluded coronary vessels: single vessel disease (SVD), 2 vessel disease (2VD), and >2 or multivessel disease (MVD). CAD risk factors were analyzed. CAD burden was assessed by number of vessels showing >70% stenosis angiographically. The relationship between CAD risk factors and CAD burden was analyzed via univariate and multivariate analysis.

Results: A total of 434 patients were included. Mean age was 56 ± 11 years with 61% Caucasians, 33% African Americans (AA), and 6% Hispanics. Females were 39.4%. Patients with SVD, 2VD, and MVD, were 264 (60.8%), 101 (23.3%) and 69 (16%) respectively. Smoking and diabetes were more prevalent in SVD group, while AA race was associated with higher incidence of MVD (table 1). HTN, HLD, diabetes, obesity, smoking, PAD, CKD were statistically similar with respect to CAD burden. On multivariate analysis, AAs {OR 0.13 [0.07-0.23]} and Hispanics {OR 0.22 [0.09-0.54]} had a lower prevalence of SVD compared to Caucasians. AA had higher odds of MVD {6.2 [2.9-12.9]} shown in table 2. Mortality was higher in MVD group compared to SVD (24.6% vs. 40.6%, p=0.01).

Conclusions: African American patients had a higher CAD burden when presenting with AMI. HTN, HLD, diabetes, obesity, PAD, smoking and CKD were statistically similar when compared for CAD burden.