The prevalence of cardiometabolic risk factors among Indians with coronary artery disease

Abstract

Background: Coronary artery disease (CAD), one of the major causes of morbidity and mortality worldwide, had become a public health problem in India during the past few decades. Cardiometabolic risk factors significantly accelerate the progression of coronary artery disease (CAD); however, whether CAD patients in India are aware of the prevalence of these risk factors is not clear yet. The aim of the study was to assess the pattern of risk factors of acute coronary syndrome (ACS) in patients with coronary artery disease (CAD) in different age groups and sex categories. Materials & Methods: The study group comprised of 100 patients of acute coronary syndrome admitted at the tertiary care centre over a period of 2 years from November 2009 to November 2011 and an equal number of age and sex matched controls. Results: Maximum number of patients of acute coronary syndrome was between 60-69 years. Youngest case of acute coronary syndrome occurred at the age of 35. The mean age of males was 54.51± 10.82 and mean age of females was 59.13± 8.67. The difference was statistically significant (p=0.0413). Thus the female cases were older as compared to male cases. It was seen that there is a male preponderance of cases with acute coronary syndrome (M:F =70:30). Chest pain was the predominant presenting symptom (98%). Out of the 100 patients with acute coronary syndrome, 31 had unstable angina, 17 had NSTEMI and 52 had STEMI. Patients of acute coronary syndrome had a significantly higher WHR (0.88±0.17 vs. 0.82±0.08) and BMI (24.59±2.99 vs. 22.63±2.22kg/m2) (p=0.0114 and 0.000 respectively). Biochemical analysis showed that Total cholesterol (179.60 ± 41.11 vs. 143.45±21.11mg/dl), Serum triglycerides (123.19±37.29 vs. 109.35±22.86mg/dl), LDL (109.05±37.62 vs. 69.02±19.30mg/dl) and Non-HDL (133.71±40.52 vs. 90.99±20.20mg/dl) were also significantly raised in cases as compared to controls (p=0.001, 0.0018, p=0.000 and p=0.000 respectively). Conclusion: Raised WHR, BMI, Hypertension, diabetes, alcohol consumption, smoking, raised total cholesterol, serum triglycerides, LDL, Non-HDL cholesterol, serum uric acid and decreased HDL were the risk factors associated with acute coronary syndrome. Hypertension, diabetes, BMI, Total cholesterol, HDL and Serum uric acid were found to be the independent predictors of acute coronary syndrome.
Keywords: Coronary artery disease (CAD), acute coronary syndrome (ACS), cardiometabolic risk factors, Indians