Carlos Augusto Cardozo de Faria

Childbearing in adolescence: intergenerational deja-vu? Evidence from a Brazilian birth cohort

BackgroundPregnancy in adolescence tends to repeat over generations. This event has been little studied in middle and low-income societies undergoing a rapid epidemiological transition. To assess this association it is important to adjust for socioeconomic conditions at different points in lifetime. Therefore, the aim of this study is to analyze the independent effect of adolescent childbearing in a generation on its recurrence in the subsequent generation, after adjusting for socioeconomic status at different points in life.MethodsThe study was conducted on a prospective cohort of singleton liveborn females from the city of Ribeirão Preto, Brazil, evaluated in 1978/79, and their daughters assessed in 2002/04. A total of 1059 mother-daughter pairs were evaluated. The women who had their first childbirth before 20 years of age were considered to be adolescent mothers. The risk of childbearing in adolescence for the daughter was modeled as a function of the occurrence of teenage childbearing in her mother, after adjustment for socio-demographic variables in a Poisson regression model.ResultsThe rate of childbearing during adolescence was 31.4% in 1978/79 and 17.1% in 2002/04. Among the daughters of the 1st generation adolescent mothers, this rate was 26.7%, as opposed to 12.7% among the daughters of non adolescent mothers. After adjustments the risk of adolescent childbearing for the 2nd generation was 35% higher for women whose mothers had been pregnant during adolescence – RR = 1.35 (95% CI 1.04-1.74).ConclusionAdolescent childbearing in the 1st generation was a predictor of adolescent childbearing in the 2nd, regardless of socioeconomic factors determined at different points in lifetime.

Tratamento de uma coorte de pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST

FUNDAMENTO: Trombolise e angioplastia transluminal coronariana (ATC) primaria sao tecnicas bem estabelecidas, mas grande parte dos pacientes com infarto agudo do miocardio com supradesnivelamento do segmento ST (IAM com SST) nao as recebem quando do atendimento hospitalar. OBJETIVO: Descrever tratamentos inicial e final e desfechos de uma coorte com IAM com SST. METODOS: Analisados, da internacao ate a alta, 158 pacientes com IAM com SST, de uma populacao total de 351 pacientes internados com (SCA) nos hospitais de Campos dos Goytacazes, entre 2004 e 2006. RESULTADOS: Dos 158 pacientes com IAM com SST, 67,7% chegaram ao hospital nos primeiros 180 minutos, 81,3% em 360 minutos e 8,4% apos doze horas. Realizados 148 estudos cinecoronariograficos (93,7%). Observadas lesoes de mais de 70% em 266 territorios arteriais. Tratamento inicial foi ATC em 41(26%), tromboliticos em 50 (32%), com 80% de sucesso. Tratamento clinico em 67 (42%). Cerca de 35% dos pacientes deveriam ser trombolizados mas nao o foram. No tratamento final foram 93 ATCs, 89 delas com sucesso angiografico (95,7), sangramento 2 (2,2), oclusao subaguda 2 (2,2%), disseccao tronco 1 (1,1), pseudo aneurisma 1 (1,1). Nenhum obito durante angioplastia; na evolucao, houve dois obitos (2,1%). Doze pacientes submetidos a cirurgia de revascularizacao miocardica (CRM). Tratamento clinico 53 (33%), com 11 obitos (20,7%). Letalidade global 9,5%, consideradas as tres formas de tratamento. CONCLUSAO: Pacientes atendidos em tempo adequado para reperfusao, porem 1/3 deles nao recebeu o procedimento. Tratamento predominante foi ATC, com baixa morbidade. Dois obitos na evolucao. Baixa letalidade global.

Impacto do tipo de incontinência urinária sobre a qualidade de vida de usuárias do Sistema Único de Saúde no Sudeste do Brasil

PURPOSE: To identify the impact of urinary incontinence (UI) on quality of life (QoL), to compare the scores of QoL domains in women with stress urinary incontinence (SUI), overactive bladder (OAB) and mixed incontinence (MUI) and to establish the association between the clinical type of UI and the impact on QoL.METHODS: Data of 181 incontinent women attended at a public hospital were collected regarding age, body mass index (BMI) and co-morbidities. Kings Health Questionnaire (KHQ) was applied and patients were classified into two groups according to the self-assessment of incontinence impact. KHQ scores were compared by the Mann-Whitney test. Depending on their urinary symptoms, women were divided into SUI, OAB and MUI groups and their scores in the KHQ domains were compared by the Kruskal-Wallis and Dunn tests. The odds ratio (OR) of a woman reporting a worse effect of UI on QoL was estimated using the binary logistic model. The control variables were: age, BMI and number of co-morbidities.RESULTS: A significant difference was found between the two groups of self-assessment of UI impact for all KHQ domains. The MUI group showed worse scores than the SUI group for all domains, and OAB group, for limitation of physical and daily activities. There was a significant difference between the odds of the women in the SUI and MUI groups reporting worse effects of UI on QoL (OR=2.9; p=0.02).CONCLUSION: As reported at other reference services, MUI was the most commom type, and urinary loss had a moderate/major impact on QoL, affecting mainly role limitations domain. The adjusted analysis showed that women with MUI had almost three times greater odds of reporting worse impact on QoL than women with SUI.PURPOSE To identify the impact of urinary incontinence (UI) on quality of life (QoL), to compare the scores of QoL domains in women with stress urinary incontinence (SUI), overactive bladder (OAB) and mixed incontinence (MUI) and to establish the association between the clinical type of UI and the impact on QoL. METHODS Data of 181 incontinent women attended at a public hospital were collected regarding age, body mass index (BMI) and co-morbidities. Kings Health Questionnaire (KHQ) was applied and patients were classified into two groups according to the self-assessment of incontinence impact. KHQ scores were compared by the Mann-Whitney test. Depending on their urinary symptoms, women were divided into SUI, OAB and MUI groups and their scores in the KHQ domains were compared by the Kruskal-Wallis and Dunn tests. The odds ratio (OR) of a woman reporting a worse effect of UI on QoL was estimated using the binary logistic model. The control variables were: age, BMI and number of co-morbidities. RESULTS A significant difference was found between the two groups of self-assessment of UI impact for all KHQ domains. The MUI group showed worse scores than the SUI group for all domains, and OAB group, for limitation of physical and daily activities. There was a significant difference between the odds of the women in the SUI and MUI groups reporting worse effects of UI on QoL (OR=2.9; p=0.02). CONCLUSION As reported at other reference services, MUI was the most commom type, and urinary loss had a moderate/major impact on QoL, affecting mainly role limitations domain. The adjusted analysis showed that women with MUI had almost three times greater odds of reporting worse impact on QoL than women with SUI.

Treatment of a cohort of patients with acute myocardial infarction and ST-segment elevation

FUNDAMENTO: Trombolise e angioplastia transluminal coronariana (ATC) primaria sao tecnicas bem estabelecidas, mas grande parte dos pacientes com infarto agudo do miocardio com supradesnivelamento do segmento ST (IAM com SST) nao as recebem quando do atendimento hospitalar. OBJETIVO: Descrever tratamentos inicial e final e desfechos de uma coorte com IAM com SST. METODOS: Analisados, da internacao ate a alta, 158 pacientes com IAM com SST, de uma populacao total de 351 pacientes internados com (SCA) nos hospitais de Campos dos Goytacazes, entre 2004 e 2006. RESULTADOS: Dos 158 pacientes com IAM com SST, 67,7% chegaram ao hospital nos primeiros 180 minutos, 81,3% em 360 minutos e 8,4% apos doze horas. Realizados 148 estudos cinecoronariograficos (93,7%). Observadas lesoes de mais de 70% em 266 territorios arteriais. Tratamento inicial foi ATC em 41(26%), tromboliticos em 50 (32%), com 80% de sucesso. Tratamento clinico em 67 (42%). Cerca de 35% dos pacientes deveriam ser trombolizados mas nao o foram. No tratamento final foram 93 ATCs, 89 delas com sucesso angiografico (95,7), sangramento 2 (2,2), oclusao subaguda 2 (2,2%), disseccao tronco 1 (1,1), pseudo aneurisma 1 (1,1). Nenhum obito durante angioplastia; na evolucao, houve dois obitos (2,1%). Doze pacientes submetidos a cirurgia de revascularizacao miocardica (CRM). Tratamento clinico 53 (33%), com 11 obitos (20,7%). Letalidade global 9,5%, consideradas as tres formas de tratamento. CONCLUSAO: Pacientes atendidos em tempo adequado para reperfusao, porem 1/3 deles nao recebeu o procedimento. Tratamento predominante foi ATC, com baixa morbidade. Dois obitos na evolucao. Baixa letalidade global.

O polimorfismo AGT*M235T na disfunção cardíaca de etiologia isquêmica aguda: projeto gisca

FUNDAMENTO: O polimorfismo AGT*M235T tem sido associado a elevados niveis sericos de angiotensinogenio (AGT), hipertensao arterial sistemica e disfuncao cardiaca (DC). OBJETIVO: Testar a hipotese de haver associacao entre polimorfismo AGT*M235T e o risco de desenvolver disfuncao cardiaca (insuficiencia cardiaca ou disfuncao sistolica ventricular esquerda assintomatica) pos-sindrome coronariana aguda (SCA), durante o periodo de internacao hospitalar. METODOS: Foram estudados 363 pacientes (idade media 62 ± 12 anos), sendo 233 (64%) homens e 130 (36%) mulheres, todos da mesma coorte, internados por SCA. Compararam-se dados clinicos e geneticos dos 117 (32,2%) que evoluiram com disfuncao cardiaca (grupo caso) com os dos 246 (67,8%), que nao desenvolveram tal condicao (grupo controle). O polimorfismo AGT*M235T foi determinado por analise de sequenciamento e estava em equilibrio de Hardy-Weinberg. RESULTADOS: Houve diferenca significativa na distribuicao dos genotipos nas mulheres, com predominio do genotipo *235MM no grupo controle (p = 0,001) e do alelo *235T no grupo caso. Em ambos os sexos, nos modelos de regressao logistica, o diagnostico de infarto de parede anterior na admissao foi fator de incremento no risco de DC, enquanto angina instavel na admissao, ausencia do alelo *235T, glicemia 60 e < 90 bpm e tabagismo atual foram fatores de reducao do risco de DC. CONCLUSAO: Este estudo sugere que a ausencia do alelo *235T do AGT contribui para a reducao do risco de disfuncao cardiaca pos-sindrome coronariana aguda.

Severity of angiographic coronary obstruction and the apolipoprotein E polymorphism in acute coronary syndromes

FUNDAMENTO: Hay evidencias de asociacion entre el polimorfismo de la apolipoproteina E (APOE) y la enfermedad coronaria, sin embargo hay controversias. OBJETIVO: Evaluar la asociacion entre el numero de vasos coronarios afectados por obstruccion significativa definida por angiografia, el polimorfismo de la APOE y las variables clinicas. METODOS: Estudio transversal multicentrico que implico a 207 pacientes (138 varones) con sindrome coronario agudo (SCA) en la ciudad de Niteroi (RJ - Brasil), los que realizaron angiografia coronaria, y determinacion del genotipo para el polimorfismo APOE *2*3*4 mediante el metodo de Restriction Fragment Length Polymorphism (RFLP). RESULTADOS: La frecuencia de los alelos APOE *2 fue del 6,8%, *3 fue del 82,5%, y *4 fue del 10,7%. En cuanto al numero de vasos lesionados, el 27% de los pacientes presentaban obstruccion uniarterial, el 33,8%, biarterial, y el 39,1%, triarterial o de tronco de la coronaria izquierda. El grado de lesion multivascular no se relaciono con la presencia del alelo *4 (p = 0,78), sino con la edad > 55 anos (p = 0,025), el ex tabaquismo (p = 0,004) y la dislipidemia (p = 0,05) en el analisis multivariado y con la enfermedad arterial coronaria previa (p = 0,05), la diabetes (p = 0,038) y el sindrome metabolico (p = 0,021) en el analisis univariado. La prevalencia de dislipidemia, diabetes e hipertension arterial sistemica (HAS) fue elevada con relacion a estudios semejantes, con aumento progresivo de la prevalencia de HAS (p = 0,59) y de diabetes (p = 0,06), segun el numero de vasos lesionados. CONCLUSION: El polimorfismo de la APOE no se asocio al numero de vasos coronarios con obstruccion significativa en cualquier grupo de edad. Por otro lado, la edad > 55 anos, el ex tabaquismo y la dislipidemia se asociaron a la lesion multivascular.BACKGROUND There is evidence of the association between the apolipoprotein E (APOE) and coronary disease; however, there are controversies. OBJECTIVE To evaluate the association between the number of coronary vessels with significant obstruction defined by angiography, the APOE polymorphism and clinical variables. METHODS This was a cross-sectional, multicenter study with 207 patients (138 men), with acute coronary syndrome (ACS), in the city of Niteroi, state of Rio de Janeiro, Brazil, who underwent coronary angiography and genotype determination for the APOE *2*3*4 polymorphism by the Restriction Fragment Length Polymorphism (RFLP) method. RESULTS The frequency of the alleles was APOE *2 - 6.8%, *3 - 82.5%, *4 - 10.7%. Regarding the number of affected vessels, 27% of patients presented monoarterial obstruction, 33.8% biarterial and 39.1% triarterial and/or left coronary trunk. The degree of multivascular lesion did not correlate with the presence of the *4 allele (p= 0.78), but with age > 55 years (p=0.025), being an ex-smoker (p=0.004) and dyslipidemia (p=0.05) at the multivariate analysis and also with previous coronary artery disease (CAD) (p=0.05), diabetes (p=0.038) and metabolic syndrome (p=0.021) at the univariate analysis. The prevalence of dyslipidemia, diabetes and systemic arterial hypertension (SAH) was elevated regarding similar studies, with progressive increases in the prevalence of SAH (p=0.59) and diabetes (p=0.06), according to the number of affected vessels. CONCLUSION The APOE polymorphism was not associated with the number of coronary vessels with significant obstruction at any age range. On the other hand, age > 55 years, being an ex-smoker and dyslipidemia associated with the multivascular lesion.

Incontinência urinária e noctúria: prevalência e impacto sobre qualidade de vida em idosas numa Unidade Básica de Saúde

Objectives: To evaluate the prevalence of urinary incontinence and its subtypes stress urinary incontinence, overactive bladder and mixed urinary incontinence, the prevalence of nocturia, and the impact of these conditions on quality of life in an elderly female population attended for vaccination in a Primary Health Care Unit in Niteroi city, State of Rio de Janeiro, Brazil. Methods: In an observational descriptive study, the Brazilian versions of the International Consultation on Incontinence Questionnaire - Short Form and of the Kings Health Questionnaire were used respectively to do the screening of women with urinary incontinence and to evaluate the impact of urinary incontinence and nocturia on quality of life. Sixty-six women took part in the survey. Results: The average age was 69.6±7.2 years. According to the International Consultation on Incontinence Questionnaire - Short Form, the prevalence of IU was 42.4%, and 42.9% of elderly incontinent women reported impact of incontinence on their daily activities. The prevalence of stress urinary incontinence, overactive bladder and mixed urinary incontinence was, respectively, 15.2%, 12.1% and 10.6%. Twenty incontinent women agreed to answer the Kings Health Questionnaire. Eleven of them (55%) reported complaints of mixed incontinence, and sixteen women (80%) presented nocturia. It was observed impact in quality of life in all domains. Conclusion: It was observed high prevalence of urinary incontinence in the studied population. According to the screening questionnaire, the most prevalent subtype of incontinence was stress urinary incontinence, whilst the use of the quality of life questionnaire showed higher prevalence of mixed incontinence. The frequency of nocturia could be estimated only for those women who answered to the Kings Health Questionnaire. There was impact on all domains of quality of life.

Tratamiento de una cohorte de pacientes con infarto agudo de miocardio con supradesnivel del segmento ST

FUNDAMENTO: Trombolise e angioplastia transluminal coronariana (ATC) primaria sao tecnicas bem estabelecidas, mas grande parte dos pacientes com infarto agudo do miocardio com supradesnivelamento do segmento ST (IAM com SST) nao as recebem quando do atendimento hospitalar. OBJETIVO: Descrever tratamentos inicial e final e desfechos de uma coorte com IAM com SST. METODOS: Analisados, da internacao ate a alta, 158 pacientes com IAM com SST, de uma populacao total de 351 pacientes internados com (SCA) nos hospitais de Campos dos Goytacazes, entre 2004 e 2006. RESULTADOS: Dos 158 pacientes com IAM com SST, 67,7% chegaram ao hospital nos primeiros 180 minutos, 81,3% em 360 minutos e 8,4% apos doze horas. Realizados 148 estudos cinecoronariograficos (93,7%). Observadas lesoes de mais de 70% em 266 territorios arteriais. Tratamento inicial foi ATC em 41(26%), tromboliticos em 50 (32%), com 80% de sucesso. Tratamento clinico em 67 (42%). Cerca de 35% dos pacientes deveriam ser trombolizados mas nao o foram. No tratamento final foram 93 ATCs, 89 delas com sucesso angiografico (95,7), sangramento 2 (2,2), oclusao subaguda 2 (2,2%), disseccao tronco 1 (1,1), pseudo aneurisma 1 (1,1). Nenhum obito durante angioplastia; na evolucao, houve dois obitos (2,1%). Doze pacientes submetidos a cirurgia de revascularizacao miocardica (CRM). Tratamento clinico 53 (33%), com 11 obitos (20,7%). Letalidade global 9,5%, consideradas as tres formas de tratamento. CONCLUSAO: Pacientes atendidos em tempo adequado para reperfusao, porem 1/3 deles nao recebeu o procedimento. Tratamento predominante foi ATC, com baixa morbidade. Dois obitos na evolucao. Baixa letalidade global.

Severidad de la lesión angiográfica coronaria y polimorfismo de la APOE en los síndromes coronarios agudos

FUNDAMENTO: Hay evidencias de asociacion entre el polimorfismo de la apolipoproteina E (APOE) y la enfermedad coronaria, sin embargo hay controversias. OBJETIVO: Evaluar la asociacion entre el numero de vasos coronarios afectados por obstruccion significativa definida por angiografia, el polimorfismo de la APOE y las variables clinicas. METODOS: Estudio transversal multicentrico que implico a 207 pacientes (138 varones) con sindrome coronario agudo (SCA) en la ciudad de Niteroi (RJ - Brasil), los que realizaron angiografia coronaria, y determinacion del genotipo para el polimorfismo APOE *2*3*4 mediante el metodo de Restriction Fragment Length Polymorphism (RFLP). RESULTADOS: La frecuencia de los alelos APOE *2 fue del 6,8%, *3 fue del 82,5%, y *4 fue del 10,7%. En cuanto al numero de vasos lesionados, el 27% de los pacientes presentaban obstruccion uniarterial, el 33,8%, biarterial, y el 39,1%, triarterial o de tronco de la coronaria izquierda. El grado de lesion multivascular no se relaciono con la presencia del alelo *4 (p = 0,78), sino con la edad > 55 anos (p = 0,025), el ex tabaquismo (p = 0,004) y la dislipidemia (p = 0,05) en el analisis multivariado y con la enfermedad arterial coronaria previa (p = 0,05), la diabetes (p = 0,038) y el sindrome metabolico (p = 0,021) en el analisis univariado. La prevalencia de dislipidemia, diabetes e hipertension arterial sistemica (HAS) fue elevada con relacion a estudios semejantes, con aumento progresivo de la prevalencia de HAS (p = 0,59) y de diabetes (p = 0,06), segun el numero de vasos lesionados. CONCLUSION: El polimorfismo de la APOE no se asocio al numero de vasos coronarios con obstruccion significativa en cualquier grupo de edad. Por otro lado, la edad > 55 anos, el ex tabaquismo y la dislipidemia se asociaron a la lesion multivascular.BACKGROUND There is evidence of the association between the apolipoprotein E (APOE) and coronary disease; however, there are controversies. OBJECTIVE To evaluate the association between the number of coronary vessels with significant obstruction defined by angiography, the APOE polymorphism and clinical variables. METHODS This was a cross-sectional, multicenter study with 207 patients (138 men), with acute coronary syndrome (ACS), in the city of Niteroi, state of Rio de Janeiro, Brazil, who underwent coronary angiography and genotype determination for the APOE *2*3*4 polymorphism by the Restriction Fragment Length Polymorphism (RFLP) method. RESULTS The frequency of the alleles was APOE *2 - 6.8%, *3 - 82.5%, *4 - 10.7%. Regarding the number of affected vessels, 27% of patients presented monoarterial obstruction, 33.8% biarterial and 39.1% triarterial and/or left coronary trunk. The degree of multivascular lesion did not correlate with the presence of the *4 allele (p= 0.78), but with age > 55 years (p=0.025), being an ex-smoker (p=0.004) and dyslipidemia (p=0.05) at the multivariate analysis and also with previous coronary artery disease (CAD) (p=0.05), diabetes (p=0.038) and metabolic syndrome (p=0.021) at the univariate analysis. The prevalence of dyslipidemia, diabetes and systemic arterial hypertension (SAH) was elevated regarding similar studies, with progressive increases in the prevalence of SAH (p=0.59) and diabetes (p=0.06), according to the number of affected vessels. CONCLUSION The APOE polymorphism was not associated with the number of coronary vessels with significant obstruction at any age range. On the other hand, age > 55 years, being an ex-smoker and dyslipidemia associated with the multivascular lesion.

Gravidade da lesão angiográfica coronariana e polimorfismo da APOE nas síndromes coronarianas agudas

FUNDAMENTO: Hay evidencias de asociacion entre el polimorfismo de la apolipoproteina E (APOE) y la enfermedad coronaria, sin embargo hay controversias. OBJETIVO: Evaluar la asociacion entre el numero de vasos coronarios afectados por obstruccion significativa definida por angiografia, el polimorfismo de la APOE y las variables clinicas. METODOS: Estudio transversal multicentrico que implico a 207 pacientes (138 varones) con sindrome coronario agudo (SCA) en la ciudad de Niteroi (RJ - Brasil), los que realizaron angiografia coronaria, y determinacion del genotipo para el polimorfismo APOE *2*3*4 mediante el metodo de Restriction Fragment Length Polymorphism (RFLP). RESULTADOS: La frecuencia de los alelos APOE *2 fue del 6,8%, *3 fue del 82,5%, y *4 fue del 10,7%. En cuanto al numero de vasos lesionados, el 27% de los pacientes presentaban obstruccion uniarterial, el 33,8%, biarterial, y el 39,1%, triarterial o de tronco de la coronaria izquierda. El grado de lesion multivascular no se relaciono con la presencia del alelo *4 (p = 0,78), sino con la edad > 55 anos (p = 0,025), el ex tabaquismo (p = 0,004) y la dislipidemia (p = 0,05) en el analisis multivariado y con la enfermedad arterial coronaria previa (p = 0,05), la diabetes (p = 0,038) y el sindrome metabolico (p = 0,021) en el analisis univariado. La prevalencia de dislipidemia, diabetes e hipertension arterial sistemica (HAS) fue elevada con relacion a estudios semejantes, con aumento progresivo de la prevalencia de HAS (p = 0,59) y de diabetes (p = 0,06), segun el numero de vasos lesionados. CONCLUSION: El polimorfismo de la APOE no se asocio al numero de vasos coronarios con obstruccion significativa en cualquier grupo de edad. Por otro lado, la edad > 55 anos, el ex tabaquismo y la dislipidemia se asociaron a la lesion multivascular.BACKGROUND There is evidence of the association between the apolipoprotein E (APOE) and coronary disease; however, there are controversies. OBJECTIVE To evaluate the association between the number of coronary vessels with significant obstruction defined by angiography, the APOE polymorphism and clinical variables. METHODS This was a cross-sectional, multicenter study with 207 patients (138 men), with acute coronary syndrome (ACS), in the city of Niteroi, state of Rio de Janeiro, Brazil, who underwent coronary angiography and genotype determination for the APOE *2*3*4 polymorphism by the Restriction Fragment Length Polymorphism (RFLP) method. RESULTS The frequency of the alleles was APOE *2 - 6.8%, *3 - 82.5%, *4 - 10.7%. Regarding the number of affected vessels, 27% of patients presented monoarterial obstruction, 33.8% biarterial and 39.1% triarterial and/or left coronary trunk. The degree of multivascular lesion did not correlate with the presence of the *4 allele (p= 0.78), but with age > 55 years (p=0.025), being an ex-smoker (p=0.004) and dyslipidemia (p=0.05) at the multivariate analysis and also with previous coronary artery disease (CAD) (p=0.05), diabetes (p=0.038) and metabolic syndrome (p=0.021) at the univariate analysis. The prevalence of dyslipidemia, diabetes and systemic arterial hypertension (SAH) was elevated regarding similar studies, with progressive increases in the prevalence of SAH (p=0.59) and diabetes (p=0.06), according to the number of affected vessels. CONCLUSION The APOE polymorphism was not associated with the number of coronary vessels with significant obstruction at any age range. On the other hand, age > 55 years, being an ex-smoker and dyslipidemia associated with the multivascular lesion.