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Category: Volume 08 Issue 02 February 2020
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Title: Association between multiple cardiovascular risk factors and coronary artery disease in young individuals belonging to an Eastern Indian Population: A histopathology and autopsy-based study

Authors: Dr Kumarjit Sarkar, Dr Shuvankar Mukherjee, Dr Nabanita Bhattacharyy

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.122

Abstract

   

Introduction: Coronary Artery Disease (CAD) is a leading cause of death in men and women at a global scale. This condition has been increasingly threatening in young individuals in the recent years. In the current study we attempt to find the association of CAD with various cardiovascular risk factors among young individuals in a regional Eastern Indian population.

Materials and Methods: CAD status of 55 subjects, determined by Histopathological (HP) analysis, following autopsy, was correlated with risk factors they were exposed in like history of smoking, alcohol consumption, physical activity level, stress level and socioeconomic status. Data were analysed using SPSS version 23.0, Armonk, NY, IBM Corp. Chi-square test with Yates correction and Fisher exact test were applied in univariate analysis. Binary logistic regression was applied to perform multivariate analysis of factors contributing to the CAD status.

Results: Univariate analysis showed that smokers and alcoholics were significantly associated with higher grade of CAD (p < .05).  Higher HP grade of CAD was significantly more commonly found among those who belonged to lower middle and below class of socio-economic status (p = .02). Also, sedentary physical activity status was significantly associated with higher level of HP grade of CAD (.000). However Binary logistic regression also showed that smoking, alcohol consumption and lower middle and below socio-economic status had significantly higher risk of developing higher HP grade of CAD while moderate physical activity status had a protective effect on development of higher HP grade.

Conclusion: There is a high incidence of CAD in the young individuals and has been significantly associated with lower socioeconomic status, history of smoking and alcohol consumption and sedentary lifestyle. Moderate physical activity however has a protective effect from the condition.

Keywords: Coronary Artery Disease, Risk Factors, Young Individuals, Histopathological Analysis, Socioeconomic status, Stress, Physical Activity, Smoking, Alcohol consumption.

References

  1. Abedinzadeh N, Pedram B, Sadeghian Y, Nodushan SMHT, Gilasgar M, Darvish M and Mokarizadeh A. A histopathological analysis of the epidemiology of coronary atherosclerosis: an autopsy study. Diagnostic Pathology. 2015;10:87.
  2. Kumar V, Abbas AK, Fausto N. Pathologic Basis of Disease. 7thSaunders,Elsevier;2009.516-524.
  3. Pandey VK, Aggarwal P, Kakkar R. Modified BG Prasad’s Socio-economic Classification-2018: The need of an update in the present scenario. Indian Journal of Community Health. January-March 2018; 30(01):82-84.
  4. Holmes TH, Rahe RH. The Social Readjustment Rating Scale. J Psychosom Res 1967;11:213–218
  5. Porwal V, Khandelwal S, Jain D, Gupta S. Histological Classification of Atherosclerosis and Correlation with Ischemic Heart Disease: A Autopsy Based Study. Annals of Pathology and Laboratory Medicine2016; 03(02): A99-A104.
  6. Phillips JE, Klein WMP. Socioeconomic Status and Coronary Heart Disease Risk: The Role of Social Cognitive Factors. Soc Personal Psychol Compass. September 2010; 4(9):704–727.
  7. Fiscella K., Tancredi D. JAMA. December 2008; 300(22): 2666–8.
  8. Janati A, Matlabi H, Allahverdipour H, Gholizadeh M, Abdollahi L. Socioeconomic Status and Coronary Heart Disease. Health Promotion Perspectives. 2011;1(2): p105-110.
  9. American Heart Association Update on CHD, 2018 (www.heart.org).
  10. Vlietstra RE, RL Frye, Kronmal RA, Sim DA, Tristani FE, Killip T.Risk Factors and Angiographic Coronary Artery Disease: A Report from the Coronary Artery Surgery Study (CASS). 1980. Journal of American Heart Association;62: 254-61.
  11. Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA .Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998 ;338(23): 1650-6.
  12. McMahan CA, Gidding SS, Fayad ZA, Zieske AW, Malcom GT, Tracy RE, Strong JP, McGill HC Jr. (for PDAY group of studies). Risk scores predict atherosclerotic lesions in young people. Arch Intern Med. 2005;165(8): 883-90.
  13. McGill HC Jr, McMahan CA, Malcom GT, Oalmann MC, Strong JP.Effects of serum lipoproteins and smoking on atherosclerosis in young men and women. The PDAY Research Group. Pathobiological Determinants of Atherosclerosis in Youth. Arterioscler Thromb Vasc Biol. Jan 1997 ;17(1): 95-106.
  14. Rissanen VJ, Pyöräla K. Cigarette smoking in relation to Coronary and Aortic Atherosclerosis. Acta Path. Microbiol.1972;80:491-500.
  15. Auerbach O, Garfinke L. Atherosclerosis and Aneurysm of Aorta in Relation to Smoking Habits and Age. The American College of Chest Physicians.1980;78: 805-809.
  16. LIFSIC AM. Alcohol consumption and atherosclerosis. BULL. WORLD HEALTH ORGAN. 1976; 53: 623-630.
  17. Djoussé L., Gaziano M.J. Alcohol Consumption and Heart Failure in Hypertensive US Male Physicians. CurrAtheroscler Rep. Apr 2008; 10(2): 117–120.

Corresponding Author

Dr Shuvankar Mukherjee

Associate Professor, Dept of Community Medicine, Raiganj Government Medical College, Raiganj, Uttar Dinajpur, West Bengal, India