الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
The study was performed on 200 patients; mean age (in years) of them was 56.94±10.30. Among them, there were 175 patients (87.5 %) who were overweight or obese with higher prevalence of HTN, hyperlipidemia, and diabetes. Normal weight patients were 25 (12.5%) with lower prevalence of HTN, hyperlipidemia, and diabetes.
According to BMI in our study, 175 patients (87.5 %) who were overweight or obese; 162 patients (92.57%) of them had significant coronary artery disease.
162 patients (81%) had significant coronary angiography findings (>70% stenosis in any of the coronary arteries); were classified to 63 patients (31.5%) had single vessel diseased, 53 patients (26.5%) had two vessels diseased, and 46 patients (23%) had three vessels diseased.
There were 114 male patients in our study; 96 male patients of them (84.21%) had significant coronary artery disease, varied from single vessel diseased to three vessels diseased. In contrast of female gender, there were 86 female patients; 66 female patients of them (76.744%) had significant coronary artery disease, almost of them were post-menopause.
As regarding diabetes as a risk factor in our study; there were 111 patients (55.5%) had type II diabetes; 100 patients (90%) of them had significant coronary artery disease, there were 127 hypertensive patients; 106 patients (83.464%) of them had significant coronary artery disease, there were 160 patients (80%) with uncontrolled level of LDL; 155 patients (96.88%) of them had significant coronary artery disease and there were 107 patients (53.5%) with history of smoking; 91 patients (85.05%) of them had significant coronary artery disease.
Obesity is related to multiple risk factors of CAD including HTN, DM, Metabolic syndrome, and dyslipidemia, while also likely being an independent risk factor for CAD. Through multiple pathways including increased angiotensin, circulating blood volume, and total peripheral resistance excess weight increases HTN risk (Dorresteijn JA, et al., 2012).
Through changes in insulin sensitivity, obesity increases the risk of DM and metabolic syndrome, which lead to changes in endothelial function, increased dyslipidemias, and other inflammatory responses all of which increase the risk of CAD (Piatti P, et al., 2003). Obesity also leads to an unfavorable lipid profile, leading to elevated CAD risk (Menuet R, et al., 2005).
A subset of obese individuals remains insulin-sensitive, the metabolically healthy obese, and maintain a CAD risk profile that is intermediate between a healthy non-obese individual and someone with Insulin- resistant obese (Marini MA, et al., 2007). While obesity increases the risk for CAD, it appears that in those with established disease, a paradox exists where the moderately obese with CAD appear to have improved mortality than those with normal weight. Current standards including weight loss and a physical activity and exercise program remain the recommendation as they have been associated with reductions in blood pressure, triglycerides, an increase in insulin sensitivity and decrease in LDL-C (Ades PA, et al., 2013).
Thus Obesity, diabetes, hypertension, hyperlipidemia, aging and male gender were correlated with severity of CAD. Thus, reduction of weight, stoppage of smoking and control of diabetes, hypertension and hyperlipidemia will improve outcome of coronary artery disease. Due to CAD high expenses of treatment and their complications; appropriate approach, prevention, and treatment lead to save economic resources and health costs. Awareness to CAD risk factors will result in achieving prevention, control, and stability. These achievements lead to lowering risk factors, treatment expenses, and improving quality of life; eventually minimize illnesses and disabilities.