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冠心病青年和老年患者中传统危险因素的患病率及基线指标评估

Prevalence of Conventional Risk Factors and Evaluation of Baseline Indices Among Young and Elderly Patients with Coronary Artery Disease.

作者信息

Adam Arsalan Majeed, Rehan Aiman, Waseem Nageen, Iqbal Unzela, Saleem Hira, Ali Muhammad Armughan, Shaikh Ali Tariq, Godil Ansab

机构信息

Student, Department of Medicine, Dow University of Health Sciences, Karachi, Sindh, Pakistan.

出版信息

J Clin Diagn Res. 2017 Jul;11(7):OC34-OC39. doi: 10.7860/JCDR/2017/27504.10281. Epub 2017 Jul 1.

Abstract

INTRODUCTION

Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality worldwide, manifesting in a variety of clinical spectrums such as an asymptomatic disease or acute coronary syndrome. It has become highly prevalent in Southeast Asia, including Pakistan. There has been little work done on the prevalence of traditional risk factors in different age groups and genders and there is a dire need to gauge the importance of baseline indices in CAD patients.

AIM

To determine the prevalence of conventional risk factors and evaluate the variations in lipid profiles, electrolyte levels and haematological indices among patients with CAD in different age groups and gender.

MATERIALS AND METHODS

This cross-sectional study was carried out in a Tertiary Care Hospital in Karachi, Sindh, Pakistan from January to June 2016, among patients with CAD. We recorded the presence of conventional risk factors and baseline indices within the first 24 hours of admission. Continuous variables were compared using Independent t-test or Mann-Whitney test and categorical variables were compared using chi-square or Fisher's exact test.

RESULTS

The most frequent risk factor was dyslipidemia (91.2%), followed by hypertension (70.4%), diabetes (51.2%), family history of CAD (40.0%) and smoking (29.2%). Total of 98.4% of patients had at least one risk factor. Diabetes and hypertension were found to be common in females; whereas, smoking was predominantly present in males. Diabetes and dyslipidemia were mostly encountered in elderly patients. The most frequent lipid alteration was low levels of High Density Lipoprotein (HDL). Cholesterol and HDL levels were found to be higher in females than males. Elderly patients had lower levels of HDL and higher levels of Cholesterol. The levels of haematological indices were found to be higher in males and younger patients. The median levels of serum sodium and potassium were found to be higher in elderly patients.

CONCLUSION

Our study findings corroborate with the findings from previous studies regarding the significance of risk factors in causing cardiovascular pathology. Medical interventions and dietary control to improve body's lipid status would be indispensable in the prevention of CAD. Deranged electrolyte levels necessitate correction of body electrolyte parameters as an adjunct in prevention strategies.

摘要

引言

冠状动脉疾病(CAD)是全球发病和死亡的主要原因,表现为多种临床症状,如无症状疾病或急性冠状动脉综合征。在包括巴基斯坦在内的东南亚地区,CAD已变得极为普遍。关于不同年龄组和性别的传统危险因素患病率的研究很少,迫切需要评估CAD患者基线指标的重要性。

目的

确定传统危险因素的患病率,并评估不同年龄组和性别的CAD患者血脂谱、电解质水平和血液学指标的差异。

材料与方法

本横断面研究于2016年1月至6月在巴基斯坦信德省卡拉奇的一家三级护理医院对CAD患者进行。我们在入院的前24小时内记录了传统危险因素和基线指标的存在情况。连续变量使用独立t检验或曼-惠特尼检验进行比较,分类变量使用卡方检验或费舍尔精确检验进行比较。

结果

最常见的危险因素是血脂异常(91.2%),其次是高血压(70.4%)、糖尿病(51.2%)、CAD家族史(40.0%)和吸烟(29.2%)。共有98.4%的患者至少有一个危险因素。糖尿病和高血压在女性中较为常见;而吸烟主要见于男性。糖尿病和血脂异常在老年患者中最为常见。最常见的血脂改变是高密度脂蛋白(HDL)水平低。发现女性的胆固醇和HDL水平高于男性。老年患者的HDL水平较低,胆固醇水平较高。男性和年轻患者的血液学指标水平较高。老年患者血清钠和钾的中位数水平较高。

结论

我们的研究结果与先前关于危险因素在导致心血管病理方面的重要性的研究结果一致。在预防CAD方面,改善身体血脂状况的医学干预和饮食控制将是必不可少的。紊乱的电解质水平需要纠正身体电解质参数,作为预防策略的辅助手段。

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