Risk Factor Patterns for Premature Versus Late-Onset Coronary Artery Disease in Iran: A Systematic Review and Meta-Analysis

Background: There are few data regarding the risk factors of premature vs late-onset Coronary Artery Disease (CAD). This study systematically reviews these risk factors in Iranian people. Methods: Medline, Web of Science, Embase and SID (Scientific Information Database; www.sid.ir) databases were searched for studies comparing CAD risk factors in young and older patients in Iran. Data extracted and pooled odds ratio (OR) with 95% Confidence Interval (CI) for each risk factor were calculated. Publication bias was evaluated by Egger’s test. Results: Seven studies (9080 participants) were included in the meta-analysis; analysis was carried out independently for each risk factor. Smoking (Odds Ratio (OR): 2.57, 95% CI: 1.96-3.37; p=<0.001), family history of CAD (OR: 2.45: 95% CI, 1.44-4.15, p<0.001), opium abuse (OR: 2.44: 95% CI, 1.22-4.88; p=0.001) and hyperlipidaemia (OR: 1.4: 95% CI, 1.13-1.73; p=0.001) were more common in premature CAD compared with older CAD patients. In contrast, diabetes mellitus (OR: 0.54: 95% CI, 0.39-0.73; p=0.0001) and hypertension (OR: 0.36, 95% CI: 0.21-0.59; p<0.001) were less prevalent. Conclusion: Risk factors were significantly different between premature and late-onset CAD. Policies regarding smoking and opium cessation and controlling hyperlipidaemia may be useful for the prevention of premature CAD in Iran.

Download Full-text

Risk Factors for Coronary Artery Disease in Patients Undergoing Coronary Angiogram at a Tertiary Level Hospital in Nepal

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v6i1.898 ◽

2022 ◽

Vol 6 (1) ◽

Author(s):

Jeetendra Mishra ◽

Achutanand Lal Karn ◽

Alok Kumar Singh ◽

Asraf Hussain ◽

Ramji Ram ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Family History ◽

Coronary Arteries ◽

History Of ◽

Premature Cad ◽

Artery Disease

Background: Ischemic heart disease is the leading cause of CVD health loss globally, as well as in each world region, followed by stroke. In Nepal, CVD was found to be the second most common non-communicable disease among indoor patients of the non-specialist hospital. Age, gender, smoking, obesity, dyslipidemia, physical inactivity, hypertension, and diabetes mellitus (DM) are established risk factors for CVD. In Nepal, hypertension is found to be the most prevalent risk factor for CVD. Aims and Objectives: This study aimed to assess risk factors for coronary artery disease in patients undergoing coronary angiograms in Nepal. This study also investigated the socio-demographic characteristics of the participants and the nature of the involvement of coronary arteries. Materials and Methods: We examined in this cross-sectional study a total of 74 patients who underwent coronary angiography (CAG) at National Medical College between May 2020 and June 2021. Patients were grouped according to the number of major epicardial coronary arteries involved in SVD, DVD, and TVD. Patients were checked for risk factors like smoking, diabetes mellitus, hypertension, dyslipidemia, family history of coronary artery disease, and obesity. Microsoft Office Excel and SPSS version 21.0 were used for data analysis. The study was approved by the ethical committee. Results: Among 74 participants 53 were male. The mean age was 59.65±10.74 years. Premature coronary artery disease was present in six patients. SVD was the commonest CAD type. Hypertension was the commonest risk factor followed by Diabetes mellitus. Hypertension, Diabetes mellitus, Family history of premature CAD, and obesity were found to be statistically significant. Keywords: CAD, Risk factors for CAD, Premature CAD, Hypertension, Diabetes, obesity, family history of CAD, dyslipidemia, Smoking, SVD, DVD, TVD, Nepal

Download Full-text

Opioid dependency and myocardial infarction: A systematic review and meta-analysis.

Current Clinical Pharmacology ◽

10.2174/1574884716666210129100455 ◽

2021 ◽

Vol 16 ◽

Author(s):

Farahnaz Rohani ◽

Arash Akhavan Rezayat ◽

Ahmadreza Zarifian ◽

Mohammad Ghasemi Nour ◽

Farveh Vakilian ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Systematic Review ◽

Coronary Artery Disease ◽

Developing Countries ◽

Coronary Artery ◽

Odds Ratio ◽

Meta Analysis ◽

Health Concern ◽

Artery Disease

Background: Coronary artery disease is a major cause of morbidity and mortality worldwide. A major health concern in developing countries is opioid addiction, which has controversial cardiovascular side effects. We aimed to investigate whether myocardial infarction (MI) and its risk factors are associated with morphine dependency in the Iranian population. Methods: Electronic databases, including PubMed, Medline, Scopus, SID, Elmnet, and Magiran were searched to find published articles including the keywords morphine, coronary artery disease, hypertension, hyperlipidemia, and diabetes mellitus. Results: Twelve studies involving 25,800 people were included in the systematic review and meta-analysis. Morphine dependency was significantly associated with MI with an adjusted odds ratio (AOR) of 2.28 (95%CI=1.26-4.11). It didn’t have significant associations with hypertension (AOR=0.952; 95%CI=0.696-1.301) nor diabetes (AOR=0.895; 95%CI=0.644-1.246). Morphine dependency also had no significant association with hyperlipidemia with a crude odds ratio (COR) of 0.906 (95%CI=0.786-1.045). Conclusion: Morphine dependency was significantly related to MI, but its risk factors were not significantly associated with morphine dependency. The increasing prevalence of opioid abuse in developing countries may be a reason for the growing incidence of MI in younger ages and individuals with no risk factors. Besides, physicians should consider the presence of impurities in morphine-based opioids and its possible effects on health.

Download Full-text

Association of smoking with coronary artery disease in Nepalese populations: a case control study

Toxicology Research ◽

10.1039/c9tx00083f ◽

2019 ◽

Vol 8 (5) ◽

pp. 677-685

Author(s):

Til Bahadur Basnet ◽

Cheng Xu ◽

Manthar Ali Mallah ◽

Wiwik Indayati ◽

Cheng Shi ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Case Control Study ◽

Case Control ◽

Psychosocial Risk ◽

Psychosocial Risk Factor ◽

Artery Disease ◽

Control Study

Abstract There are well-known traditional risk factors for coronary artery disease (CAD). Among them, smoking is one of the most prominent and modifiable risk factors. This study aims to determine the magnitude of smoking as a risk factor for CAD in the Nepalese population. A hospital-based age- and sex-matched case–control study was carried out with a total of 612 respondents. Bivariate analysis showed that the risk of developing CAD in ex-smokers and current smokers was higher (odds ratio (OR): 1.81 (confidence interval (CI): 1.21–2.7) and OR: 5.2 (CI: 3.4–7.97)), with p-values less than 0.004 and <0.00001, respectively, compared to the risk in never smokers. From stratified socio-demographic, cardio-metabolic, behavioural and psychosocial risk factor analysis, smoking was found to be associated with CAD in almost all subgroups. In the subsequent multivariate analysis, adjustment for socio-demographic, cardio-metabolic and psychosocial risk factors showed a steady increase in risk. However, further adjustment for behavioural risk factors (alcohol use and physical activity) showed that the risk was attenuated by 59% in current smokers. After adjusting for the covariates, current smokers and ex-smokers had an increased risk of CAD (OR: 6.64, 95% CI: 3.64–12.12, p < 0.00001; OR: 1.89, 95% CI: 1.08–3.31, p < 0.012, respectively) compared with non-smokers. In conclusion, smoking was found to increase the risk of CAD in the Nepalese population.

Download Full-text

Prospective Analysis after Coronary-artery Bypass Grafting: Platelet GP IIIa Polymorphism (HPA-1b /PlA2) Is a Risk Factor for Bypass Occlusion, Myocardial Infarction, and Death

Thrombosis and Haemostasis ◽

10.1055/s-0037-1613827 ◽

2000 ◽

Vol 83 (03) ◽

pp. 404-407 ◽

Cited By ~ 43

Author(s):

Michael Klein ◽

Hans Dauben ◽

Christiane Moser ◽

Emmeran Gams ◽

Rüdiger Scharf ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Odds Ratio ◽

Bypass Surgery ◽

Artery Bypass ◽

Bypass Grafting ◽

Hereditary Risk ◽

Artery Disease

SummaryRecently, we have demonstrated that human platelet antigen 1b (HPA-1b or PlA2) is a hereditary risk factor for platelet thrombogenicity leading to premature myocardial infarction in preexisting coronary artery disease. However, HPA-1b does not represent a risk factor for coronary artery disease itself. The aim of our present study was to evaluate the role of HPA-1b on the outcome in patients after coronaryartery bypass surgery. We prospectively determined the HPA-1 genotype in 261 consecutive patients prior to saphenous-vein coronaryartery bypass grafting. The patients were followed for one year. Among patients with bypass occlusion, myocardial infarction, or death more than 30 days after surgery, the prevalence of HPA-1b was significantly higher than among patients without postoperative complications (60 percent, 6/10, vs. 24 percent, 58/241, p <0.05, odds ratio 4.7). Using a stepwise logistic regression analysis with the variables HPA1b, age, sex, body mass index, smoking (pack-years), hypertension, diabetes, cholesterol and triglyceride concentration, only HPA-1b had a significant association with bypass occlusion, myocardial infarction, or death after bypass surgery (p = 0.019, odds ratio 4.7). This study shows that HPA-1b is a hereditary risk factor for bypass occlusion, myocardial infarction, or death in patients after coronary-artery bypass surgery.

Download Full-text

Revascularization versus Medical Management of Coronary Artery Disease in Prerenal Transplant Patients: A Meta-Analysis

Cardiorenal Medicine ◽

10.1159/000487763 ◽

2018 ◽

Vol 8 (3) ◽

pp. 192-198

Author(s):

Haroon Kamran ◽

Eric Kupferstein ◽

Navneet Sharma ◽

Gagandeep Singh ◽

James R. Sowers ◽

...

Keyword(s):

Coronary Artery Disease ◽

Renal Transplantation ◽

Coronary Artery ◽

Medical Management ◽

Odds Ratio ◽

Patient Population ◽

Fixed Effects ◽

Coronary Revascularization ◽

Meta Analysis ◽

Artery Disease

Introduction: End-stage renal disease requiring renal transplantation comprises a growing patient population at risk for cardiovascular disease (CVD) morbidity and mortality in large part due to accelerated atherosclerosis. Consequently, these patients are at even higher risk of major surgical CVD mortality. A paucity of research has addressed the posttransplantation CVD outcomes related to different treatment strategies in this patient population and therefore, there are no specific preoperative guidelines regarding management of coronary artery disease in this high-risk population undergoing renal transplantation. Objective: Through meta-analysis we compare coronary revascularization to medical management prior to renal transplantation in patients who are found to have significant obstructive coronary artery disease. Results: A total of 6 studies were deemed suitable out of 777 articles reviewed. This included 260 patients who received medical management and 338 who received coronary revascularization. There were 36 events in the revascularization and 57 events in the medical management group. One study only reported hazard ratios but no CVD outcomes. Comprehensive Meta-Analysis software was used to calculate pooled odds ratio with 95% confidence intervals (CI) for the fixed effects. The data is presented as forest plots. The pooled odds ratio with 95% CI for the fixed effects was 1.415 (95% CI 0.885–2.263), p = 0.147, indicating that there is no difference in CVD outcomes between pretransplant treatment strategy. This observation suggests that the CVD outcomes posttransplantation are not affected when optimal medical therapy is used instead of coronary revascularization.

Download Full-text

Genetic variants of PEAR1 and ischemic clinical outcomes in coronary artery disease patients: a systematic review and meta-analysis

Pharmacogenomics ◽

10.2217/pgs-2021-0022 ◽

2021 ◽

Author(s):

Xinyi Zhang ◽

Sicong Li ◽

Yuxuan Zhao ◽

Ningjia Tang ◽

Tong Jia ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Clinical Outcomes ◽

Odds Ratio ◽

Meta Analysis ◽

Electronic Database ◽

Artery Disease ◽

Relationship Of ◽

The Relationship ◽

Ischemic Events

Aim: The aim of this study was to assess the association between PEAR1 polymorphisms and ischemic clinical outcomes. Materials & methods: We searched the electronic database for articles on the relationship of PEAR1 SNPs and ischemic events in patients with coronary artery disease (CAD) up to October 2020. Results: A total of 9914 patients with CAD from six studies focusing on 12 SNPs of PEAR1 were included in this study. The A allele of rs12041331 were associated with ischemic events (odds ratio: 1.40; 95% CI: 1.04–1.88; p = 0.03). The AA homozygotes of rs2768759 was related to a higher risk of ischemic events than carriers of the C allele (odds ratio: 2.08; 95% CI: 1.09–3.97; p = 0.03). Conclusion: PEAR1 rs12041331 and rs2768759 are significantly associated with ischemic events in patients with CAD.

Download Full-text

Lifestyle related risk factors of coronary artery disease patients in Nepal

European Journal of Public Health ◽

10.1093/eurpub/ckz186.199 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

P Gaudel ◽

M Kaunonen ◽

S Neupane ◽

K Joronen ◽

A M Koivisto ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Categorical Variables ◽

Dietary Habit ◽

Total Study Population ◽

Related Risk ◽

Study Population ◽

Artery Disease

Abstract Background Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality and serious health problem worldwide. It is important to observe lifestyle related risk factors in patients with CAD for effective planning and implementation of secondary prevention strategies. The aim of this study is to describe the prevalence of lifestyle related risk factor habits among the patients with CAD. Methods A cross-sectional study was conducted among CAD patients in a tertiary care national heart center in Kathmandu, Nepal. Six lifestyle related factors (dietary habit, smoking, alcohol consumption, stress, physical activity and adherence to medication) and Body Mass Index were used as the risk factors of CAD in this study. Individual face-to-face structured interview was conducted using culturally validated standard instruments. The descriptive characteristics were presented as frequencies and percentages for categorical variables and as mean ± standard deviation (SD) or median and interquartile range (IQR) otherwise. Results In total study population, the mean age of the patients was 59.9 years and 76% were male. Patients having any three risk factors out of seven were the most common (36%) followed by two risk factors (25%) and four risk factors (22%). About 32% of study population were current smokers, whereas 29% were former smokers. Likewise, 31% of the total were physically inactive. Majority of the patients 95% had perceived moderate stress. Conclusions The prevalence of lifestyle related risk factors is high among CAD patients in study population. Combination of any three lifestyle related risk factors were the most common among patients. Therefore, studies focusing on lifestyle risk factor modification intervention on particular groups is recommended. Key messages Need to improve awareness about lifestyle related risk factors among CAD patients. Highlight the importance of lifestyle counselling.

Download Full-text

Sudden Cardiac Death in the Young

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.119.006470 ◽

2020 ◽

Vol 13 (10) ◽

Cited By ~ 1

Author(s):

Francis J. Ha ◽

Hui-Chen Han ◽

Prashanthan Sanders ◽

Kim Fendel ◽

Andrew W. Teh ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Body Mass Index ◽

Coronary Artery ◽

Sudden Cardiac Death ◽

Odds Ratio ◽

Cardiac Death ◽

Arrhythmic Death ◽

Sudden Arrhythmic Death Syndrome ◽

Artery Disease

Background: Sudden cardiac death (SCD) in the young is devastating. Contemporary incidence remains unclear with few recent nationwide studies and limited data addressing risk factors for causes. We aimed to determine incidence, trends, causes, and risk factors for SCD in the young. Methods and Results: The National Coronial Information System registry was reviewed for SCD in people aged 1 to 35 years from 2000 to 2016 in Australia. Subjects were identified by the International Classification of Diseases , Tenth Revision code relating to circulatory system diseases (I00–I99) from coronial reports. Baseline demographics, circumstances, and cause of SCD were obtained from coronial and police reports, alongside autopsy and toxicology analyses where available. During the study period, 2006 cases were identified (median age, 28±7 years; men, 75%; mean body mass index, 29±8 kg/m 2 ). Annual incidence ranged from 0.91 to 1.48 per 100 000 age-specific person-years, which was the lowest in 2013 to 2015 compared with previous 3-year intervals on Poisson regression model ( P =0.001). SCD incidence was higher in nonmetropolitan versus metropolitan areas (0.99 versus 0.53 per 100 000 person-years; P <0.001). The most common cause of SCD was coronary artery disease (40%), followed by sudden arrhythmic death syndrome (14%). Incidence of coronary artery disease–related SCD decreased from 2001–2003 to 2013–2015 ( P <0.001). Proportion of SCD related to sudden arrhythmic death syndrome increased during the study period ( P =0.02) although overall incidence was stable ( P =0.22). Residential remoteness was associated with coronary artery disease–related SCD (odds ratio, 1.44 [95% CI, 1.24–1.67]; P <0.001). For every 1-unit increase, body mass index was associated with increased likelihood of SCD from cardiomegaly (odds ratio, 1.08 [95% CI, 1.05–1.11]; P <0.001) and dilated cardiomyopathy (odds ratio, 1.04 [95% CI, 1.01–1.06]; P =0.005). Conclusions: Incidence of SCD in the young and specifically coronary artery disease–related SCD has declined in recent years. Proportion of SCD related to sudden arrhythmic death syndrome increased over the study period. Geographic remoteness and obesity are risk factors for specific causes of SCD in the young.

Download Full-text

Risk factors of premature coronary artery disease in Iran: A systematic review and meta‐analysis

European Journal of Clinical Investigation ◽

10.1111/eci.13124 ◽

2019 ◽

Vol 49 (7) ◽

Cited By ~ 5

Author(s):

Hoorak Poorzand ◽

Konstantinos Tsarouhas ◽

Seyyed Amin Hozhabrossadati ◽

Nastaran Khorrampazhouh ◽

Yones Bondarsahebi ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Meta Analysis ◽

Premature Coronary Artery Disease ◽

Artery Disease

Download Full-text

Association of Lipoprotein-Associated Phospholipase A2 with Coronary Artery Disease in African-Americans and Caucasians

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2009-2498 ◽

2010 ◽

Vol 95 (5) ◽

pp. 2376-2383 ◽

Cited By ~ 18

Author(s):

Erdembileg Anuurad ◽

Zeynep Ozturk ◽

Byambaa Enkhmaa ◽

Thomas A. Pearson ◽

Lars Berglund

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

African American ◽

Risk Factor ◽

Cardiovascular Risk ◽

Coronary Artery ◽

African Americans ◽

Coronary Angiography ◽

Pla2 Activity ◽

Artery Disease

Abstract Context: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is bound predominately to low-density lipoprotein and has been implicated as a risk factor for coronary artery disease (CAD). Objective: We investigated the association between Lp-PLA2 and CAD in a biethnic African-American and Caucasian population. Design: Lp-PLA2 mass, activity, and index, an integrated measure of mass and activity, and other cardiovascular risk factors were determined in 224 African-Americans and 336 Caucasians undergoing coronary angiography. Main Outcome Measures: We assessed the distribution of Lp-PLA2 levels and determined the predictive role of Lp-PLA2 as a risk factor for CAD. Results: Levels of Lp-PLA2 mass and activity were higher among Caucasians compared with African-Americans (293 ± 75 vs. 232 ± 76 ng/ml, P < 0.001 for mass and 173 ± 41 vs. 141 ± 39 nmol/min/ml, P < 0.001 for activity, respectively). However, Lp-PLA2 index was similar in the two groups (0.61 ± 0.17 vs. 0.64 ± 0.19, P = NS). In both ethnic groups, Lp-PLA2 activity and index was significantly higher among subjects with CAD. African-American subjects with CAD had significantly higher Lp-PLA2 index than corresponding Caucasian subjects (0.69 ± 0.20 vs. 0.63 ± 0.18, P = 0.028). In multivariate regression analyses, after adjusting for other risk factors, Lp-PLA2 index was independently (odds ratio 6.7, P = 0.047) associated with CAD in African-Americans but not Caucasians. Conclusions: Lp-PLA2 activity and index was associated with presence of CAD among African-Americans and Caucasians undergoing coronary angiography. The findings suggest an independent impact of vascular inflammation among African-Americans as contributory to CAD risk and underscore the importance of Lp-PLA2 as a cardiovascular risk factor.

Download Full-text