Moezi Bady Seyed Ali, Salmani Fatemeh, Zarepur Ehsan, Kazemi Toba, Partovi Neda, Hanafi Bojd Nazanin, Khosravi Bizhaem Saeede, Khosravi Farsani Alireza, Mohammadifard Noushin, Nouhi Fereidoon, Alikhasi Hassan, Sadeghi Masoumeh, Roohafza Hamidreza, Hassannejad Razieh, Rabiei Katayoun, Salehi Nahid, Solati Kamal, Lotfizadeh Masoud, Ghaffari Samad, Javanmardi Elmira, Salari Arsalan, Dehghani Mostafa, Cheraghi Mostafa, Haybar Habib, Madadi Reza, Azdaki Nahid, Sarrafzadegan Nizal
Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.
Geriatric Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.
J Cardiovasc Thorac Res. 2025 Mar 18;17(1):49-57. doi: 10.34172/jcvtr.025.33190. eCollection 2025 Mar.
Premature coronary artery disease (PCAD) has an ascending trend especially in developing countries. This study have investigated the risk factors and severity of developing CAD across various Iranian ethnicities.
This case-control study was done on 3015 Iranian patients undergoing coronary artery angiography, across highly populated Iranian ethnicities including Bakhtiari, Azari, Qashqai, Arab, Fars, Kurd, Gilak, and Lur. This study was performed over three years in 14 capitals of provinces in Iran headed by Isfahan Cardiovascular Research Center, by including men≤60 years old and women≤70 years undergoing coronary artery angiography. If they had coronary stenosis above 75% (more than 50% in the left main), they were categorized as Case group.The effects of conventional risk factors as well as psychosocial ones including age, gender, weight, Body mass index (BMI), economic status, cigarette smoking, drugs of abuse, stress, anxiety, diabetes, hypertension, etc. were determined in each ethnicity using decision tree statistical method. Also, via logistic regression method, the odds of incidence of CAD in each ethnicity were specified against the Fars ethnicity (the predominant ethnicity in Iran).
The most common risk factor among different ethnicities was age and male gender. Also, among the Iranian ethnicities, Kurd had the lowest chance while Gilak and Azari had the highest chance of developing PCAD as compared to the Fars ethnicity. Investigation of the behavioral and psychological dimensions indicated that stress was significantly higher among those without coronary artery involvement as compared to those with this involvement. The decision tree model could predict that among Gilakis, Fasting blood sugar (FBS) above 126 and in Lurs opium as well as diastolic blood pressure above 85, and in Kurds male gender would considerably increase the odds of developing CAD.
The model obtained from the decision tree indicated that although variables of age, gender, cigarette, and opium are among the main risk factors for involvement of coronary arteries among young adult patients, in different ethnicities, the risk level of each of these risk factors in incidence of PCAD is different. This means among Kurds, age, among Gilakis diabetes, and among Lurs opium are more important.
早发性冠状动脉疾病（PCAD）呈上升趋势，尤其是在发展中国家。本研究调查了伊朗不同种族患CAD的风险因素及严重程度。
本病例对照研究对3015名接受冠状动脉造影的伊朗患者进行，这些患者来自伊朗人口众多的不同种族，包括巴赫蒂亚里、阿扎里、卡什卡伊、阿拉伯、法尔斯、库尔德、吉拉克和卢尔。本研究在伊朗14个省份的省会城市由伊斯法罕心血管研究中心牵头进行，为期三年，纳入年龄≤60岁的男性和年龄≤70岁接受冠状动脉造影的女性。如果他们的冠状动脉狭窄超过75%（左主干超过50%），则被归类为病例组。使用决策树统计方法确定每个种族中传统风险因素以及心理社会因素（包括年龄、性别、体重、体重指数（BMI）、经济状况、吸烟、药物滥用、压力、焦虑、糖尿病、高血压等）的影响。此外，通过逻辑回归方法，确定每个种族患CAD的几率相对于法尔斯族（伊朗的主要种族）的情况。
不同种族中最常见的风险因素是年龄和男性性别。此外，在伊朗各民族中，与法尔斯族相比，库尔德人患PCAD的几率最低，而吉拉克人和阿扎里人患PCAD的几率最高。对行为和心理维度的调查表明，未患冠状动脉疾病的人群中的压力明显高于患冠状动脉疾病的人群。决策树模型可以预测，在吉拉克人中，空腹血糖（FBS）高于126，在卢尔人中鸦片以及舒张压高于85，在库尔德人中男性性别会显著增加患CAD的几率。
从决策树获得的模型表明，虽然年龄、性别、香烟和鸦片等变量是年轻成年患者冠状动脉受累的主要风险因素，但在不同种族中，这些风险因素中每一个在PCAD发病中的风险水平是不同的。这意味着在库尔德人中年龄更重要，在吉拉克人中糖尿病更重要，在卢尔人中鸦片更重要。
