Premature coronary artery disease in India: coronary artery disease in the young (CADY) registry

Iyengar, Shamanna S.; Gupta, R.M.; Ravi, Sandhya; Thangam, Saral; Alexander, Thomas; Manjunath, Cholenahalli Nanjappa; Keshava, R.; Patil, Chandrakant B.; Sheela, Annie; Sawhney, Jps

doi:10.1016/j.ihj.2016.09.009

Cited by 51 publications

(59 citation statements)

References 27 publications

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“…According to Iyengar et al (Coronary Artery Disease in the Young [CADY] registry), 16 the prevalence of standard coronary risk factors (smoking, hypertension, diabetes, and dyslipidemia) is high in premature CAD in India, which is similar to previous case-control studies. 17 Women with premature CAD have greater prevalence of metabolic risk factors than men.…”

Section: Discussionsupporting

confidence: 66%

Coronary Artery Disease in Young Females: Current Scenario

Kher

Sathyanarayan

2017

Ind J Car Dis Wom

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IntroductionCoronary artery disease (CAD) remains unrecognized, particularly in young women. In the modern era, women are selfdependent and are well aware of their rights, but unfortunately their awareness and attitude toward their health especially cardiovascular diseases is largely ignored. Though the women constitute 48% of the total population in India, CAD remains a major formidable health problem in women. Indeed, it is rightly said that coronary heart disease (CHD), Keywords► coronary artery disease ► percutaneous coronary intervention ► coronary heart disease ► myocardial infarction ► coronary angiogram ► left ventricle AbstractBackground Despite coronary artery disease (CAD) being the leading cause of morbidity and mortality in females, women still have been underrepresented in clinical trials. We have abundant data for young males with obstructive CAD, but there is scarcity of data for young females. Objectives To observe the presentation, disease pattern, risk factors, ventricular function, and percutaneous coronary intervention (PCI) efficiency in young females in comparison with young males with obstructive CAD who required PCI. Material and Methods We conducted a hospital-based retrospective study and analyzed the data of young patients (< 45 years of age) who had undergone PCI over the past 2 years. We observed the demographic profile, clinical findings, and investigative and treatment modalities in these patients. Results Total 200 young patients underwent PCI for obstructive CAD over a span of 2 years. Among these patients, 42 patients were females. In comparison to males, hypertension (43.7% vs. 69.1%, p ¼ 0.008) was more among females, which was statistically significant. Smoking was predominant in young males than young females. Also, males presented as acute ST-elevation MI, whereas females presented with unstable angina or non-ST-elevation MI (NSTEMI). Multivessel involvement, LV dysfunction, success of PCI, and complication rates were similar in both the groups. Anemia was more predominant in females (< 11 g/dL) than in males (< 13 g/dL). Also, complexity of lesion on angiography (B 2 or C type of lesions) was greater in females than males, which was statistically significant (p ¼ 0.02). Conclusion Diabetes, hypertension, and other metabolic factors play a very important role in the onset of CAD in young women. NSTEMI and complex lesions showed greater predominance in females than in males in our study. However, the success and complication rate of PCI remained the same.

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Section: Discussionsupporting

confidence: 66%

Coronary Artery Disease in Young Females: Current Scenario

Kher

Sathyanarayan

2017

Ind J Car Dis Wom

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“…Mean age of patients in the present study was 54.54 ± 8.89 years which is higher than some Indian study. [2][3][4] Common pre-morbid illnesses associated in study population were smoking, hypertension, diabetes dyslipidemia which are similar to interheart study. 5 Hypertension was seen (32%), which is higher compared to Indian data (from centre for chronic disease control) on risk factors in coronary artery disease where hypertension was seen in 17-22% of patients with coronary artery disease.…”

Section: Discussionsupporting

confidence: 75%

Role of N Terminal-Pro Brain Natriuretic Peptide in predicting the Severity of Coronary Artery Disease in Patients with Chronic Stable Angina

Saha¹,

Mandal²

2019

IJCMSR

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“…39 The term ''young'' varied from 40 [40][41][42] to 55 43 and 60 years old 44 or specifically for men below 55 years and for women below 65 years. 45 As there is no universally accepted cut-off for age to determine "young" patients, in this review, a single definition was not used, but rather, the cutoffs or ranges used by the authors of the individual studies were accepted and discussed. CAD with its long asymptomatic period demands early effective preventive measures.…”

Section: Discussionmentioning

confidence: 99%

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

Poorzand

Tsarouhas

Hozhabrossadati

et al. 2019

Eur J Clin Investigation

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Background The aim of this study was to determine the mean age at which coronary artery disease (CAD) hase decreased in recent years in Iran. This systematic review and meta‐analysis compares the prevalence of different risk factors of premature CAD (PCAD) in patients vs healthy individuals. Methods Medline, Web of Science, Embase and Scientific Information Database were searched for studies about PCAD risk factors in Iran until 28 October 2017. Observational studies of Iranians, comparing risk factors between patients with PCAD and age‐ and sex‐matched healthy subjects, were included. Fixed‐effects and random‐effects model were used for pooling data. Odds ratio (OR) with 95% CI and mean difference were used for effect size estimation among studies. Results Twelve studies were eligible for meta‐analysis. Diabetes mellitus (OR: 2.4, 95% CI: 1.9‐3.03; P = 0.0001, I2 = 25.5%; P = 0.2), family history of CAD (OR: 2.09, 95% CI: 1.22‐3.6; P = 0.007, I2 = 86%; P = 0.0001), dyslipidaemia (OR: 2.05, 95% CI: 1.15‐3.64; P = 0.01, I2 = 54%; P = 0.08), smoking (OR: 1.65, 95% CI: 1.11‐2.46; P = 0.01, I2 = 77.2%; P = 0.000) and hypertension (OR: 1.35, 95% CI: 1.21 to‐1.50; P < 0.001, I2 = 31%, P = 0.1) associated with PCAD. Sensitivity analysis demonstrated that patients with PCAD had significantly lower levels of high‐density lipoprotein (HDL) cholesterol and significantly higher levels of triglycerides compared to healthy subjects (MD: −2.56, 95% CI: −3.54 to −1.58, P < 0.001, I2 = 42%, P = 0.01 and MD: 21.17, 95% CI: 14.73‐27.62, P < 0.001, I2 = 80.12%, P < 0.001, respectively). It should be noted that although high levels of heterogeneity in LDL and HDL values among the studies were observed, when dyslipidaemia was studied as a binary variable, no significant heterogeneity among studies was observed. Conclusion Diabetes mellitus, family history of CAD, dyslipidaemia, smoking, and hypertension were significantly and positively associated with CAD in young adults compared to healthy age‐ and sex‐matched population in Iran.

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Premature coronary artery disease in India: coronary artery disease in the young (CADY) registry

Cited by 51 publications

References 27 publications

Coronary Artery Disease in Young Females: Current Scenario

Coronary Artery Disease in Young Females: Current Scenario

Role of N Terminal-Pro Brain Natriuretic Peptide in predicting the Severity of Coronary Artery Disease in Patients with Chronic Stable Angina

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

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