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

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

scholarly journals Ankle-brachial Index and associated factors in individuals with coronary artery disease

2020 ◽  
Vol 66 (4) ◽  
pp. 407-413
Author(s):  
Saulo Henrique Salgueiro de Aquino ◽  
Isabelle Tenório Melo ◽  
Carlos Dornels Freire de Souza ◽  
Francisco de Assis Costa
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Ankle Brachial Index ◽  
Chi Square ◽  
Significant Difference ◽  
History Of ◽  
Artery Disease

SUMMARY OBJECTIVE Analyzing the association between ABI and the main risk factors for coronary artery disease in coronary patients. METHODS Were selected 156 adult patients from a hospital in Maceió, Alagoas. Were evaluated with risk factors age, obesity, hypertension, diabetes mellitus, smoking, and dyslipidemia. PAOD screening was performed by the ankle-brachial index (ABI). The Mann-Whitney, chi-square, and Fisher’s exact tests were used. Confidence Interval of 95% and a significance of 5%. RESULTS 67.3% (n=105) males, 52.6% (n=82) elderly, 23.1% (n = 34) obese, 72.4% 6% (n=113) hypertensive, 34.6% (n=54) diabetics, 53.2% (n=83) smokers, 34.6% (n=54) dyslipidemic and 70.5% (n=110) with a family history of CAD. 16.7% (n=26) of the individuals presented PAOD. Three factors were associated with PAOD: age group ≥ 60 years (OR:3.656; p=0.005), diabetes mellitus (OR:2.625; p=0.024) and hypertension (OR:5.528; p=0.008). No significant difference was observed in the variables smoking, dyslipidemia, family history of CAD, and obesity. CONCLUSION The independent risk factors for PAOD were age, diabetes mellitus, and systemic arterial hypertension.

scholarly journals Clinical profile of premenopausal female patients with coronary artery disease

2018 ◽  
Vol 6 (7) ◽  
pp. 2285
Author(s):  
Unnikrishnan Kartha T. D. ◽  
Ambili N. R. ◽  
Donna Mathew ◽  
Renymol B.
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Premenopausal Women ◽  
History Of ◽  
Study Population ◽  
Premenopausal Female ◽  
Premature Cad ◽  
Artery Disease

Background: Coronary artery disease is becoming the leading cause of death in the world. The incidence of CAD in females has increased rapidly in the past decades. This study aimed to analyze the clinical profile of premenopausal women with CAD and elucidate on the possible risk factors.Methods: Premenopausal female patients admitted with an acute coronary syndrome as diagnosed by history, ECG and laboratory tests were recruited. Clinical and biochemical parameters were recorded.Results: Mean age of study participants was 41.6±8.18 yrs. Unstable angina (60%) was the most common clinical presentation. Proportion of women with various risk factors of CAD in our study population were as follows dyslipidemia (65%), family history of premature CAD (57.5%), hypertension (55%), diabetes mellitus (42.5%), hypothyroidism (40%), PAD (37.5%), CKD (35%) and SLE (20%). Most (95%) of the study population had high LDL-c. Three fourth (77.5%) of the study population had low HDL Approximately half of the study population had fatty liver on ultrasonography. Triglyceridemia was found in 72.5% of the study population.Conclusions: Premature CAD is increasingly evident in young premenopausal women in India. Premenopausal CAD in India is of multi factorial causation and dyslipidemia, hypertension, diabetes mellitus, central obesity and family history of premature CAD play a crucial role in its development.

scholarly journals A retrospective case-control study of modifiable risk factors and cutaneous markers in Indian patients with young coronary artery disease

2012 ◽  
Vol 1 (3) ◽  
pp. 1-8 ◽  
Author(s):  
Amitesh Aggarwal ◽  
Sourabh Aggarwal ◽  
Ashish Goel ◽  
Vishal Sharma ◽  
Shridhar Dwivedi
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Central Obesity ◽  
Clinical Markers ◽  
Low Hdl ◽  
History Of ◽  
Premature Cad ◽  
Artery Disease

Objective Indians have the highest risk rates for coronary artery disease (CAD) among all ethnic groups. There is a paucity of data on the risk factors and clinical markers associated with premature CAD. We aimed to determine whether young CAD is due to preventable lifestyle-related factors and cutaneous clinical markers are useful in identifying at-risk patients. Design Single-centre retrospective study. Setting Tertiary care center. Participants A total of 292 patients (age ≤40 years) who presented with acute CAD between January 2005 and June 2009 and 92 age, and gender-matched controls. Major outcome measures Details of smoking, family history of premature CAD, waist size, blood sugar and lipid profile. Clinical evidence of arcus juvenilis, premature greying of hair and premature baldness sought. Results Dyslipidaemia (91%), smoking (74.3%), low high-density lipoprotein cholesterol (HDL-C) (68.9%), central obesity (47.7%) and greying of hair (34.9%) were the most commonly associated factors. Compared with male patients, females had greater prevalence of dyslipidaemia, low HDL-C, central obesity, hypertension, diabetes and family history of premature CAD. The presence of cutaneous markers was significantly associated with premature CAD. Conclusions CAD in young Indian people is multifactorial; dyslipidaemia, low HDL-C, smoking, hypertension, central obesity and family history of premature CAD are the most common risk factors. Smoking in men and central obesity in women are the most prevalent factors. Clinicians should be highly suspicious of patients with presence of cutaneous markers, and they should be followed intensively for lifestyle modifications.

scholarly journals Risk factors for atherosclerosis in children and adolescents with family history of premature coronary artery disease

10.2223/1153 ◽  
2004 ◽  
Vol 80 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Ceres C. Romaldini ◽  
Hugo Issler ◽  
Ary L. Cardoso ◽  
Jayme Diament ◽  
Neusa Forti
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Children And Adolescents ◽  
Premature Coronary Artery Disease ◽  
History Of ◽  
Artery Disease

scholarly journals Relationship between the Severity of Coronary Artery Disease and Cardiovascular Risk Factors in Acute Coronary Syndrome: Based on Tehran Heart Center’s Data Registry

2021 ◽  
Author(s):  
Negar Omidi ◽  
Saeed Sadeghian ◽  
Mojtaba Salarifar ◽  
Arash Jalali ◽  
Seyed Hesameddin Abbasi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Family History ◽  
Gensini Score ◽  
Coronary Syndrome ◽  
Artery Disease

Background: Acute coronary syndrome (ACS) is one of the main causes of mortality worldwide. We sought to evaluate the correlation between the severity of coronary artery disease (CAD) and conventional coronary artery risk factors in a large cohort of patients with ACS. Methods: This study included all patients admitted to the coronary care unit with a diagnosis of ACS between 2003 and 2017. The patients were divided into 2 groups: 1) unstable angina and 2) myocardial infarction. The aims of this study were to evaluate the effects of the risk factors and extension of coronary artery stenosis in patients with ACS according to the Gensini score. Results: Of a total 40 319 patients who presented with ACS, 18 862 patients (mean age =60.4±11.14 y, male: 67.2%) underwent conventional coronary angiography and met our criteria to enter the final analysis. The median of the Gensini score was 50 (25–88) in the study population. The multivariable analysis showed that age, sex, diabetes mellitus, hypertension, dyslipidemia, family history, cigarette smoking, opium consumption, and myocardial infarction increased the risk of positive Gensini scores. All the aforementioned risk factors, except cigarette smoking and opium consumption, increased the severity of stenosis in those with positive Gensini scores. The strongest relationship was seen vis-à-vis myocardial infarction, sex, and diabetes mellitus. Conclusion: Our findings suggest that age, sex, diabetes mellitus, dyslipidemia, hypertension, family history, and myocardial infarction have significant effects on the severity of CAD. The obesity paradox in relation to CAD should be taken into consideration and needs further investigation in patients with ACS.

scholarly journals Screening for Premature Coronary Artery Disease (CAD) using Coronary Artery Calcium (CAC) Score: A Primary Prevention Pilot Study

2021 ◽  
Vol 16 (1) ◽  
pp. 134-149
Author(s):  
Hamat Hamdi Che Hassan ◽  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Primary Prevention ◽  
Coronary Artery Calcium ◽  
Overweight And Obesity ◽  
Premature Coronary Artery Disease ◽  
History Of ◽  
Artery Disease

Acute Coronary Syndrome (ACS) events can be accelerated by positive family history of young coronary artery disease (CAD). Risk factors assessment sometimes fail to predict ACS occurrence. Additional investigations with coronary artery calcium (CAC) score can be used independently in screening for primary prevention in some population. This was a cross-sectional study in asymptomatic population with first degree relatives (FDR) having premature CAD compared with a matched population with no family history of CAD from September 2017 to March 2018 at the Cardiology Clinic of Univeristi Kebangsaan Malaysia Medical Centre. A total of 36 subjects were recruited with equal number in each group. Female were the majority in each group (66.7%). The FDR group were slightly younger compared to the control group [mean (SD) age 36.9 (4.9) against 38 (3.8), respectively). Both groups represent high risk factors including overweight and obesity, abdominal obesity as well as dyslipidemia. Newly diagnosed dyslipidemia was significant in the group with family history (83.3% versus 44.4%, P<0.01). Both groups were screened either into the low or moderate risk Framingham Risk Score group. CAC score was higher in family history group (11.1% vs 0%, P>0.05). In conclusion, CAC may be irrelevant for screening in younger population. However, the yield of other risk factor is still alarming.

scholarly journals Risk Factor Burden and Long‐Term Prognosis of Patients With Premature Coronary Artery Disease

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Michel Zeitouni ◽  
Robert M. Clare ◽  
Karen Chiswell ◽  
Jawan Abdulrahim ◽  
Nishant Shah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Premature Cad ◽  
Artery Disease ◽  
Long Term Prognosis

Background Coronary artery disease (CAD) is increasing among young adults. We aimed to describe the cardiovascular risk factors and long‐term prognosis of premature CAD. Methods and Results Using the Duke Databank for Cardiovascular Disease, we evaluated 3655 patients admitted between 1995 and 2013 with a first diagnosis of obstructive CAD before the age of 50 years. Major adverse cardiovascular events (MACEs), defined as the composite of death, myocardial infarction, stroke, or revascularization, were ascertained for up to 10 years. Cox proportional hazard regression models were used to assess associations with the rate of first recurrent event, and negative binomial log‐linear regression was used for rate of multiple event recurrences. Past or current smoking was the most frequent cardiovascular factor (60.8%), followed by hypertension (52.8%) and family history of CAD (39.8%). Within a 10‐year follow‐up, 52.9% of patients had at least 1 MACE, 18.6% had at least 2 recurrent MACEs, and 7.9% had at least 3 recurrent MACEs, with death occurring in 20.9% of patients. Across follow‐up, 31.7% to 37.2% of patients continued smoking, 81.7% to 89.3% had low‐density lipoprotein cholesterol levels beyond the goal of 70 mg/dL, and 16% had new‐onset diabetes mellitus. Female sex, diabetes mellitus, chronic kidney disease, multivessel disease, and chronic inflammatory disease were factors associated with recurrent MACEs. Conclusions Premature CAD is an aggressive disease with frequent ischemic recurrences and premature death. Individuals with premature CAD have a high proportion of modifiable cardiovascular risk factors, but failure to control them is frequently observed.

Abstract 1528: Gender Differences In The Effect Of Traditional Cardiac Risk Factors On Age At Presentation With Stemi

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
William Herzog ◽  
Thomas Aversano
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Female Gender ◽  
Smoking History ◽  
Men And Women ◽  
History Of ◽  
Males And Females ◽  
Artery Disease

For coronary artery disease (CAD), female gender is ’protective’, so that women typically present with clinically apparent CAD a decade later than men. We examined the extent to which traditional cardiovascular risk factor influence the age at presentation with STEMI in men and women. The Cardiovascular Patient Outcomes Research Team (C-PORT) primary PCI registry includes 7197 patients (5070 males and 2109 females) who presented with STEMI at 33 participating hospitals. The table below depicts the average age at presentation with STEMI in males and females with and without diabetes, hypercholesterolemia, hypertension, a family history of coronary artery disease and smoking history (current or former). The effect of smoking, family history and hypertension on age at presentation remained significant in multivariate analysis in both men and women. In both males and females, a family history of CAD and a positive smoking history are associated with presentation with STEMI at a younger age. Both have a greater effect in females. This is particularly true of smoking with lowers the age of presentation by 9 years in women, compared with 3.8 years in men. Male and female patients with a history of hypertension are older at presentation with STEMI, perhaps because the anti-ischemic effects of anti-hypertensive medications. We conclude that while the effect of most traditional risk factors for CAD on age at presentation with STEMI are similar in men and women, smoking lowers the age at presentation to a much greater degree in women. In women who do not smoke, STEMI is delayed for a decade or more compared to men; for women who do, the protective effect of female gender is nearly obliterated.

Abstract 14925: Inverse Association between Family History of Premature Coronary Artery Disease and the Risk of Death in Patients with Coronary Artery Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ahmed Abdi Ali ◽  
Abdel Aziz Shaheen ◽  
Danielle A Southern ◽  
Mei Zhang ◽  
Merril Knudston ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Family History ◽  
Clinical Characteristics ◽  
System Level ◽  
Premature Coronary Artery Disease ◽  
Inverse Association ◽  
History Of ◽  
Premature Cad ◽  
Artery Disease

Background: Family history (FHx) of premature coronary artery disease (CAD) is an established cardiovascular risk factor. However the impact of FHx on outcomes of patients with CAD is unclear. Methods & Results: The Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) Program is an inclusive prospective registry of patients undergoing coronary angiography. Between April 2002 and Mar 2013, 99,667 patients were enrolled. 30,030 (30%) patients reported FHx, defined as a first degree relative with premature CAD (males <55, females <65 years). We investigated the association between FHx and all-cause mortality at 1 year, using multivariable logistic regression, adjusting for clinical characteristics, comorbidities, and the extent of CAD. Patients with normal angiography (15.2%) were excluded. Compared to those without FHx, those with FHx were younger (60.1 vs 64.0 years, p<0.0001), more likely female (30.5% vs 29.5%; p=0.0018), and were less likely to have previously diagnosed CAD, congestive heart failure, stroke, or chronic kidney disease (all p<0.0001) Conversely, those with FHx were more likely current smokers (31.8% vs 25.3%) and to have hypertension (68.8% vs 65.5%) and dyslipidemia (75.7% vs 68.1%), all p<0.0001). The indication for angiography was an acute coronary syndrome (ACS) in 55% of both groups (p=0.57), and the extent of CAD was similar. Overall, FHx was associated with reduced 1-year mortality in fully adjusted models (odds ratio [OR] 0.56, 95% CI 0.51 to 0.62). This protective association was present in patients with and without a previous CAD event (OR 0.66 [95% CI 0.60 to 0.78] vs 0.53 [95% CI 0.47 to 0.59], respectively), and in patients with and without an ACS (OR 0.56 [95% CI 0.50 to 0.63] vs 0.56 [95% CI 0.48 to 0.65], respectively). There was slight attenuation of association with age, but FHx remained protective even in those aged 80 or more (OR 0.72, 95% CI 0.57 to 0.90). Conclusion: In patients with angiographic CAD, a family history of premature CAD is associated with lower mortality, independent of clinical characteristics, mode of presentation, and extent of disease. Further investigation of potential patient- and system-level mediators of this seemingly paradoxical relationship is required.

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