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Risk variables for coronary artery disease in Asian Indians
A Ramachandran1, I Sathyamurthy, C Snehalatha
1Diabetes Research Centre and MV Hospital for Diabetes, Madras, India. ramachandran@vsnl.com
Insights
This study found that factors like age, body mass index, and certain cholesterol levels are independently linked to coronary artery disease (CAD) in Indian men. Diabetes and hypertension were also more common in those with CAD.
Area of Science:
- Cardiology
- Public Health
Background:
- Coronary artery disease (CAD) is a significant health concern globally and in India.
- Large-scale studies identifying specific risk factors for CAD in Indian populations with confirmed diagnoses are limited.
Purpose of the Study:
- To investigate the association of anthropometric variables, lipoproteins, and coagulation parameters with angiographically confirmed CAD in Indian men.
- To identify independent predictors of CAD in this demographic.
Main Methods:
- A cross-sectional study involving 447 men aged 25 years and above, categorized as having CAD or not.
- Exclusion criteria included treatment with aspirin or lipid-lowering agents, and presence of renal, hepatic, or thyroid diseases.
- Statistical analyses included univariate and multiple logistic regression to assess variable associations.
Main Results:
- Diabetes and hypertension were significantly more prevalent in men with CAD.
- Abnormalities in lipid profiles (except lipoprotein(a)) and higher antibodies to oxidized low-density lipoprotein were associated with CAD.
- Independent predictors of CAD included age, body mass index, very-low-density lipoprotein cholesterol, total to high-density lipoprotein cholesterol ratio, and fibrinogen.
Conclusions:
- Several lipid abnormalities and elevated fibrinogen are associated with CAD in Asian Indian men.
- Factors such as age, BMI, VLDL-C, Total/HDL-C ratio, and fibrinogen are independent risk factors for CAD in this population.
- Lipoprotein(a) did not show a significant association with CAD in this study cohort.
Abstract:
No large study from India has addressed the association of risk variables with coronary artery disease (CAD) in angiographically proved cases. In this study, we analyzed the association of anthropometric variables, lipoproteins, and coagulation parameters with CAD in those cases proved by coronary angiography. A cross-sectional study of 447 men > or = 25 years old, classified as with CAD or without CAD, was performed. Men treated with aspirin or lipid-lowering agents, and those with renal, hepatic, or thyroid diseases were excluded. Associations of these variables with CAD were evaluated by univariate and multiple logistic regression analyses. The effect of diabetes on the CAD profile was also analyzed. Prevalences of diabetes and hypertension were significantly higher among those with CAD (p <0.001 for both). Lipid profile abnormalities, except lipoprotein (Lp(a)), were associated with CAD. Antibodies to oxidized low-density lipoprotein was higher in patients with CAD. Fibrinogen levels were higher in CAD, but plasminogen activator inhibitor-1 did not show an association with CAD. In the multiple logistic regression analysis, age, body mass index, very-low-density lipoprotein cholesterol, total to high-density lipoprotein cholesterol ratio, and fibrinogen showed significant independent association with CAD. Several lipid abnormalities were associated with CAD in Asian Indians, but no significant association was seen with Lp(a) levels.