印度极低龄冠状动脉疾病中血脂异常的重要性：一项基于注册的研究。

Importance of Dyslipidemias in Very Premature Coronary Artery Disease in India: A Registry-based Study.

机构信息

Medical Student, Norwich Medical School, University of East Anglia, Norwich, United Kingdom.

Associate Professor, Department of Pharmacology, LBS College of Pharmacy, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.

出版信息

J Assoc Physicians India. 2024 Sep;72(9):14-18. doi: 10.59556/japi.72.0663.

DOI:10.59556/japi.72.0663

PMID:39291510

Abstract

BACKGROUND AND OBJECTIVE

Premature coronary artery disease (CAD) is an important cause of death in India. To identify risk factors in patients with premature CAD, we performed a registry-based study.

METHODS

Consecutive patients admitted for percutaneous coronary intervention (PCI) from October 2020 to June 2021 were recruited. The patients were classified into three groups-group I (very premature CAD < 40 years), group II (premature CAD 40-59 years), and group III (nonpremature CAD > 60 years). Major risk factors were determined, and intergroup comparison was performed.

RESULTS

A total of 627 patients were enrolled (men 541, women 86). Group I had 79 (12.4%), group II had 420 (66.9%), and group III had 128 (20.4%) patients. The prevalence of risk factors in groups I, II, and III, respectively, were-CAD family history in 45.1, 41.1, and 26.6% ( = 0.005), current smoking/tobacco use in 29.1, 21.0, and 10.2% ( = 0.002), hypertension in 31.6, 43.6, and 59.4% ( < 0.001), and diabetes in 22.8, 34.3, and 46.1% ( < 0.001). High total cholesterol (>170 mg/dL) was present in 50.0, 38.0, and 29.9% ( = 0.005), nonhigh-density lipoprotein (HDL) cholesterol (>100 mg/dL) in 76.9, 64.4, and 54.5% ( = 0.001), low-density lipoprotein (LDL) cholesterol (>70 mg/dL) in 85.9, 76.8, and 76.4% ( = 0.167), triglycerides (>150 mg/dL) in 56.4, 45.3, and 33.1% ( = 0.001), and very low density lipoprotein (VLDL) cholesterol (>30 mg/dL) in 24.4, 10.4, and 9.4% ( = 0.005). Age- and sex-adjusted odds ratios (OR) and 95% confidence intervals (CI) for smoking/tobacco use in groups I and II compared to group III, respectively, were 3.17 (1.60-6.27) and 2.59 (1.51-4.46); high total cholesterol 2.39 (1.29-4.13) and 1.42 (0.92-2.17); high non-HDL cholesterol 2.70 (1.45-5.03) and 1.48 (0.99-2.20); and high triglycerides 2.57 (1.44-4.58) and 1.64 (1.08-2.49).

CONCLUSION

Important coronary risk factors in very premature and premature CAD in India are a family history of CAD, any tobacco use, and dyslipidemias (raised total, LDL, non-HDL, and VLDL cholesterol and triglycerides).

摘要

背景与目的

早发性冠心病（CAD）是印度的一个重要死亡原因。为了确定早发性 CAD 患者的风险因素，我们进行了一项基于注册的研究。

方法

连续纳入 2020 年 10 月至 2021 年 6 月因经皮冠状动脉介入治疗（PCI）入院的患者。患者分为三组-组 I（极早发性 CAD < 40 岁）、组 II（早发性 CAD 40-59 岁）和组 III（非早发性 CAD > 60 岁）。确定主要危险因素，并进行组间比较。

结果

共纳入 627 例患者（男性 541 例，女性 86 例）。组 I 有 79 例（12.4%），组 II 有 420 例（66.9%），组 III 有 128 例（20.4%）。各组的危险因素患病率分别为-CAD 家族史 45.1%、41.1%和 26.6%（ = 0.005），当前吸烟/使用烟草 29.1%、21.0%和 10.2%（ = 0.002），高血压 31.6%、43.6%和 59.4%（ < 0.001），糖尿病 22.8%、34.3%和 46.1%（ < 0.001）。高总胆固醇（>170 mg/dL）分别为 50.0%、38.0%和 29.9%（ = 0.005），非高密度脂蛋白（HDL）胆固醇（>100 mg/dL）分别为 76.9%、64.4%和 54.5%（ = 0.001），低密度脂蛋白（LDL）胆固醇（>70 mg/dL）分别为 85.9%、76.8%和 76.4%（ = 0.167），甘油三酯（>150 mg/dL）分别为 56.4%、45.3%和 33.1%（ = 0.001），极低密度脂蛋白（VLDL）胆固醇（>30 mg/dL）分别为 24.4%、10.4%和 9.4%（ = 0.005）。与组 III 相比，组 I 和 II 中吸烟/使用烟草的年龄和性别调整比值比（OR）和 95%置信区间（CI）分别为 3.17（1.60-6.27）和 2.59（1.51-4.46）；高总胆固醇 2.39（1.29-4.13）和 1.42（0.92-2.17）；高非高密度脂蛋白胆固醇 2.70（1.45-5.03）和 1.48（0.99-2.20）；和高甘油三酯 2.57（1.44-4.58）和 1.64（1.08-2.49）。