Coronary artery disease prognosis
forecast
The course of coronary heart disease (CHD) is influenced by various factors:
The annual mortality rate without therapeutic measures increases with the number of affected vessels and is highest (at over 30%) for the narrowing of the main trunk of the left coronary artery.
The prognosis of coronary artery disease also depends on the extent to which the heart muscle is insufficiently supplied. The frequency, duration, and severity of angina attacks increases the risk of having a heart attack.
If the pumping function of the left ventricle decreases with the existing or increasing oxygen supply (ischemia), the patient's prognosis worsens and the implantation of a defibrillator may become necessary.
The progression of coronary artery calcification (atherosclerosis of the coronary arteries) is largely dependent on the risk factors that the patient has. Nicotine abstinence, weight reduction and normalization of blood pressure as well as lowering the total cholesterol in the blood are important factors in avoiding CHD deterioration.
Read more on the topic: Life expectancy in coronary artery disease
prophylaxis
The prophylaxis of coronary heart disease (CHD) consists of the above primary and secondary prevention and essentially amounts to avoiding risk factors that promote or favor the development of CHD.
Which factors positively influence the prognosis of coronary heart disease?
For the prognosis of coronary artery disease (CHD), the degree of stenosis (degree of obstruction) of the coronary vessels plays a role. The smaller the stenosis, the better the heart can compensate for the limitations. This improves the prognosis.
The stenosis is divided into four different degrees of severity: 0 to 40% mean a low risk, with 40 to 70% the beginning of restrictions can be felt during physical exertion. These restrictions are more noticeable with a 70 to 90% stenosis. If the stenosis is over 90%, symptoms can be expected even at rest.
Concomitant diseases in particular also play a major role in the prognosis. The healthier an affected person is and the fewer other illnesses there are, the more positive the prognosis.
Particularly critical illnesses include high blood pressure, a heart attack, stroke, peripheral arterial disease (blockage in the leg arteries) or an aortic aneurysm (bulging of the main artery).
Metabolic diseases are also important factors. A balanced cholesterol ratio is an important prognostic factor. The more HDL cholesterol and the less LDL cholesterol a person has, the more positive the prognosis for CHD is.
Last but not least, the biological prognostic factors should not be neglected. The younger a person is, the better their prognosis is. Statistically, the prognosis for women is better than for men.
Genetics also play a role. Those who don't have ancestors who suffered from heart disease have a better prognosis. It is assumed that there are no genetic patterns in these families that favor CHD or its rapid progression.
Anyone who would like to work for a positive prognosis for coronary heart disease should above all pay attention to a balanced diet. The so-called Mediterranean diet is recommended here, with a lot of vegetables and fish being eaten. Red meat in particular should be avoided if possible. High-fat food does not have a positive effect either. Furthermore, alcohol consumption and smoking should be avoided in order to improve the prognosis. An improvement in CHD can also be achieved through regular sport and exercise. However, depending on the severity of the disease, the beginning of physical activity should take place under regular medical supervision.
Read more on this topic at: Diet for heart disease
Which factors negatively influence the prognosis of coronary heart disease?
The most important factor that negatively affects the prognosis of coronary artery disease (CHD) is the severity of the disease.
Coronary artery disease is a disease of the coronary arteries. These can be narrowed by calcifications and plaque deposits. This results in an insufficient supply of blood, oxygen and other nutrients for the tissue behind it.
The CHD can be classified according to the size of the stenosed (narrowed) part of the vessel. The stronger the stenosis, the worse the prognosis for coronary artery disease.
Concomitant diseases also play a major role in relation to the prognosis: If the person concerned has already suffered a heart attack, the prognosis worsens. The prognosis is also poorer if there are diseases that indicate the formation of blood clots or a circulatory disorder in the vessels. This includes a stroke (blood clot in the brain) but also peripheral arteial occlusive disease (PAOD), which causes narrowing of the arteries of the legs.
Kidney disease, such as kidney insufficiency (kidney weakness), is also a negative prognostic factor, as the kidneys play a key role in regulating blood pressure.
Other negative prognostic factors are age and male gender. The older a person is, the less the heart can compensate for existing problems. Statistically speaking, men die more frequently and at a younger age than women from CAD.
The metabolic status is also important for the prognosis. A high LDL cholesterol level encourages the formation of further plaques and therefore worsens the prognosis.
High blood pressure also has a negative effect on CHD. Likewise, people with diabetes mellitus (blood sugar disease) suffer more often from CAD, and the disease progresses more quickly.
Family history also plays a role. If people in the family have already died of a heart attack or coronary heart disease, this indicates unfavorable genetic conditions. Lastly, the prognosis also depends on lifestyle. Smoking, regular alcohol consumption, little sport / exercise and an unbalanced diet worsen the prognosis.
