Evaluation of Risk Factors of Premature Coronary Artery Disease in Patients From North India: A Rising Epidemic

Gautam Kumar Bunker, Manoj Patidar, Devendra Atal, R. Meena
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Abstract

Background: The incidence of premature coronary artery disease (PCAD) is on rising trend in low- and middle-income countries. Considering the limited reports, the current study was conducted to evaluate the prevalence, various predisposing factors, and coronary angiographic findings of PCAD in North India. Methods: Study design—hospital-based analytical cross-sectional study. Setting: Outpatient and inpatient units of a tertiary cardiac center in North India. Two hundred sequential patients (170 males and 30 females) with acute coronary syndrome were evaluated for history of risk factors, measurement of anthropometric parameters, biochemical blood examination, electrocardiogram, complete dental examination, and angiographic assessment of coronary artery lesion. Patients with acute infection or chronic inflammatory disorders were excluded. Patients were divided into PCAD (age ≤45 years) and mature CAD. Results: The prevalence of PCAD was 15% (N = 30). PCAD had higher rates of family history of CAD (P < 0.001), tobacco consumption (P = 0.01), smoking (P = 0.004), and single-vessel disease (SVD) (P < 0.001). Premature CAD group had significantly lower mean fasting blood glucose (105 ± 41 mg/dL vs 127 ± 45 mg/dL) levels. Conclusion: Family history of CAD, smoking, and tobacco consumption are important risk factors of PCAD. SVD is more common in PCAD. Screening the susceptible population at risk and controlling the cardiovascular risk factors will help reduce the epidemic and consequences of PCAD.
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北印度患者过早冠状动脉疾病的危险因素评估:一种正在上升的流行病
背景:在低收入和中等收入国家,过早冠状动脉疾病(PCAD)的发病率呈上升趋势。考虑到有限的报道,本研究旨在评估印度北部PCAD的患病率、各种易感因素和冠状动脉造影结果。方法:研究设计-基于医院的分析横断面研究。设置:门诊和住院单位的三级心脏中心在印度北部。对200例急性冠状动脉综合征患者(男性170例,女性30例)进行危险因素史、人体测量参数、血液生化检查、心电图、完整牙科检查和冠状动脉病变血管造影评估。排除急性感染或慢性炎症性疾病患者。患者分为PCAD(年龄≤45岁)和成熟型CAD。结果:PCAD患病率为15% (N = 30)。PCAD患者有较高的冠心病家族史(P < 0.001)、吸烟家族史(P = 0.01)、吸烟家族史(P = 0.004)和单血管疾病家族史(P < 0.001)。早发冠心病组平均空腹血糖水平(105±41 mg/dL vs 127±45 mg/dL)显著降低。结论:冠心病家族史、吸烟、烟草消费是发生冠心病的重要危险因素。SVD在pad中更为常见。筛查高危易感人群,控制心血管危险因素,有助于减少pad的流行和后果。
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