Investigating Genetic and Other Determinants of First-Onset Myocardial Infarction in Malaysia: Protocol for the Malaysian Acute Vascular Events Risk Study (Preprint)

Abstract

UNSTRUCTURED Introduction: Although the burden of premature myocardial infarction (MI) is high in Malaysia, direct evidence on the determinants of MI in this multi-ethnic population remains sparse. The Malaysian Acute Vascular Events Risk (MAVERIK) study is a retrospective case-control study established to enable investigation of genomic, lipid-related and other determinants of acute MI in Malaysia. To our knowledge, it represents the largest case-control study of MI and related traits in Malaysia. In this paper, we report the study’s design and initial results. Methods: By June 2019, MAVERIK had enrolled about 2500 patients with first-ever MI and 2500 controls without cardiovascular disease (CVD), frequency-matched by age, sex and ethnicity, from 17 hospitals in Malaysia. For each participant, serum and whole blood have been collected and stored. Clinical, demographic and behavioural information has been obtained using a 200-item questionnaire. Results: Tobacco consumption, history of diabetes, hypertension, markers of visceral adiposity, indicators of lower socioeconomic status, and family history of coronary disease were more prevalent in cases than controls. Crude and adjusted (age, sex) logistic regression models for traditional risk factors indicated that current smoking, previous smoking, history of high blood pressure, history of diabetes mellitus, family history of CHD and obesity (BMI>30) were associated with MI in age- and sex-adjusted models. Conclusion: The MAVERIK study can serve as a useful platform to investigate genetic and other risk factors for MI in an under-studied South-East Asian population. It should help to hasten discovery of disease-causing pathways and to inform regionally appropriate strategies that optimise public health action.