The hallmark of the pathophysiology of CAD is the development of atherosclerotic plaque. High sensitivity CRP (hsCRP) is thought to be the best predictor of coronary artery disease in some studies although uses for it in a practical setting are controversial. Markers of inflammation are also strong risk factors for coronary artery disease. An individual's 10-year risk of atherosclerotic cardiovascular disease can be calculated using the ASCVD equation available online on the American Heart Association portal. Increased low-density lipoproteins (LDL) increased the risk for CAD and elevated high-density lipoproteins (HDL) decrease the incidence of CAD. Hypercholesterolemia remains an important modifiable risk factor for CAD. The male gender is more predisposed than the female gender. In 2016, the prevalence of smoking among the United States among adults was found to be at 15.5 %. Smoking remains the number one cause of cardiovascular diseases. In the US, better primary care in the middle and higher socioeconomic groups has pushed the incidence towards the later part of life. In the Western world, a faster-paced lifestyle has led people to eat more fast foods and unhealthy meals which has led to an increased prevalence of ischemic heart diseases. Modifiable risk factors include smoking, obesity, lipid levels, and psychosocial variables. Non-modifiable factors include gender, age, family history, and genetics. Etiologic factors can be broadly categorized into non-modifiable and modifiable factors. All rights reserved.Coronary artery disease is a multifactorial phenomenon. Physician in the emergency department should be aware of the importance of clinical examination in the risk stratification in patients presenting with ACS.Ĭopyright © 2012 Elsevier Inc. High Killip class was independent predictors of mortality in ST-elevation myocardial infarction and non-ST-elevation acute coronary syndrome. In conclusion, across ACS, patients with higher Killip class had worse clinical profile and were less likely to be treated with evidence-based therapy. Classes II, III, and IV were associated with higher adjusted odds of death in ST-elevation myocardial infarction (odds ratio 2.1, 95% confidence interval 1.25-3.69 OR 6.1, 95% CI 3.41-10.86 and OR 28, 95% CI 15.24-54.70, respectively) and non-ST-elevation acute coronary syndrome (adjusted OR 2.4, 95% CI 1.24-4.82 OR 3.2,95% 1.49-7.02 and OR 9.8, 95% CI 3.79-25.57, respectively). In comparison to Killip Class I, patients with higher Killip class had greater prevalence of cardiovascular risk factors, presented late, were less likely to have angina, and were less likely to receive antiplatelet, statins, and β-blockers. High Killip classes were defined in 22% of patients. Patients' characteristics and in-hospital outcomes were analyzed. Patients were categorized according to Killip classification at presentation (Classes I, II, III, and IV). In 2007 and over 5 months, 6704 consecutive patients with ACS were enrolled in the Gulf Registry of Acute Coronary Events. The purpose of this study was to assess the prognostic value of the Killip classification at the presentation in patients with acute coronary syndrome (ACS).
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