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.
J Assoc Physicians India. 2024 Sep;72(9):14-18. doi: 10.59556/japi.72.0663.
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.
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.
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).
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).
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。
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。
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）。
印度极早发性和早发性 CAD 的重要冠心病危险因素是 CAD 家族史、任何形式的烟草使用和血脂异常（总胆固醇、LDL、非 HDL 和 VLDL 胆固醇及甘油三酯升高）。
