Coronary Artery Disease: An emerging Epidemic in Nepal

Maskey, Arun; Arun, S; Pandey, Madhav

doi:10.3126/njh.v2i2.26031

Cited by 22 publications

(20 citation statements)

References 3 publications

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“…This observational retrospective study identifies the overall prevalence of significant coronary Stenosis (> 50%) is only 13 (2.3%) which is very low compared to the studies that have been done so far. In general Nepalese population, the prevalence of CAD is estimated to be around 5% [15].…”

Section: Recommendations Cor Loementioning

confidence: 99%

Prevalence of Coronary Artery Disease in Rheumatic Patients Undergoing Valve Surgeries in Nepal

Joshi¹,

Timala²,

Pradhan³

et al. 2018

Cardiol Vasc Res

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Background: Preoperative coronary angiogram is routinely performed in high risk age-group in rheumatic population undergoing valve surgery at our centre. Preoperative angiogram itself carries risks. We sought to evaluate the prevalence of coronary artery disease in those patients so that recommendations on preoperative angiogram can be made. Methods: We reviewed medical records of patients above 35 years who underwent valve surgery from January 2015 to July 2017. We defined significant coronary artery disease as ≥50% stenosis in one or more major coronaries. Overall prevalence and age-specific prevalence were determined. Results: A total of 675 patients above 35 years of age undergoing valve surgery were assessed for eligibility. Among them, 563 (84.3%) patients had rheumatic heart disease. However, only 337 patients had undergone preoperative angiogram and were included in the analysis. Overall prevalence of coronary artery disease was 13(2.3%). Agespecific prevalence was as follows: age-group 40-50 years 0 of 127 patients (0%), 51-55 years 6 of 95 patients (6.3%), 55-60 years 1 of 56 patients (1.7%), and more than 60 years 6 of 52 patients (11.5%). Prevalence did not significantly differ between male and female population. Conclusion: The prevalence of coronary artery disease in rheumatic patients requiring valve replacement seems to be lower compared to the available prevalence data of general Nepalese population. There were no cases of angiographically significant coronary heart disease in the age between 40-50 years. However, the results of this study should be inferred with caution and prospectively planned study with risk factor analysis is warranted.

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Section: Recommendations Cor Loementioning

confidence: 99%

Prevalence of Coronary Artery Disease in Rheumatic Patients Undergoing Valve Surgeries in Nepal

Joshi¹,

Timala²,

Pradhan³

et al. 2018

Cardiol Vasc Res

View full text Add to dashboard Cite

show abstract

“…Few studies have assessed the CVD burden in Nepal. The prevalence of coronary artery disease was reported to be 5% in a study conducted in six hospitals of Kathmandu in 2003 12 , and 5.7% in a population-based study in eastern Nepal in 2009 13 . The prevalence of rheumatic heart disease was 0.9 per thousand among 5-15 years old children in Kathmandu in 2013 14 .…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Disease Trends in Nepal - An Analysis of Global Burden of Disease Data 2017

Bhattarai

Aryal²,

Pyakurel

et al. 2020

Preprint

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Background Cardiovascular diseases (CVDs) are the leading cause of death and disease burden globally, disproportionately affecting low and middle-income countries. The continued scarcity of literature on CVDs burden in Nepal has thwarted efforts to develop population-specific prevention and management strategies. This article reports the burden of CVDs in Nepal including, prevalence, incidence, and disability basis as well as trends over the past two decades by age and gender. The findings from this study provide a base for public health priorities and for creating evidence-informed policies.Methods We used the Institute of Health Metrics and Evaluation (IHME)’s Global Burden of Diseases (GBD) database on cardiovascular disease mortality rates, prevalence, incidence, disability-adjusted life-years (DALYs), years of life lost (YLLs) and years lived with disability (YLDs) from Nepal to describe the most recent data available (2017) and trends by age, gender and year from 1990 to 2017. Tables, graphs and histograms are used to compare patterns and trends across all metrics. Data are presented as percentages or as rates per 100,000 population.Results In 2017, CVDs contributed to 26·9% of total deaths and 12·8% of total DALYs in Nepal. Ischemic heart disease and stroke were the predominant CVDs, contributing 16·4% and 7·5% to total deaths and 7·5% and 3·5% to total DALYs, respectively. Cardiovascular disease incidence and mortality rates have increased from 1990 to 2017, with the burden greater among males and among older age groups. The leading risk factors for CVDs were determined to be high systolic blood pressure, high low density lipoprotein (LDL) cholesterol, smoking, air pollution, a diet low in whole grains, and a diet low in fruit.Conclusion CVDs are a major public health problem in Nepal contributing to the high DALYs with unacceptable numbers of premature deaths. There is an urgent need to address the increasing burden of CVDs and their associated risk factors, particularly high blood pressure, body mass index (BMI) and unhealthy diet.

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“…Since then, the numbers have climbed steadily with a 40-fold increase in diagnosis by 2003. 4 The WHO Rose Angina Questionnaire (RAQ) was designed in 1962 to assess the probability of underlying coronary artery disease in epidemiologic studies of population groups. Since then, the screening tool has been validated for use in many countries to detect CHD in epidemiological research as well as in ED to detect MI.…”

Section: Introductionmentioning

confidence: 99%

Rose Angina Questionnaire: Validation in emergency department to detect myocardial infarction in a tertiary hospital of eastern Nepal

Poudel

Bhandari

Malla

et al. 2019

Hong Kong Journal of Emergency Medicine

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Background: Rose Angina Questionnaire (RAQ) is a useful screening questionnaire for ischemic heart disease validated in different settings; however, its diagnostic ability to predict myocardial infarction (MI) in the emergency is less clear. Objectives: To find out the usefulness of RAQ to predict MI in patients presenting to the emergency. Methods: A cross-sectional study was conducted at the BP Koirala Institute of Health Sciences (BPKIHS), a teaching hospital in eastern Nepal from 1 January to 30 March 2017, after ethical clearance from the Institutional Review Committee. Informed consent was obtained from the patients for their anonymised information to be published in this study The samples were collected from 100 patients with chest pain aged 40 to 70 years presenting to the emergency. RAQ was applied and its performance to detect MI was compared with emergency and cardiologist diagnosis of MI. Sensitivity, specificity, positive predictive value and negative value were calculated along with descriptive analysis. Results: A total of 100 patients were analysed with the mean age of 63.78 years (SD 11.60) and male to female ratio of 1.94. RAQ detected 58 cases (63.8%) with emergency department (ED) diagnosis of MI (true positive) and identified 3 (33.3%) cases with non-MI (true negative). The true positive rate for RAQ to detect MI after cardiologist consultation was 71.6%. RAQ had a sensitivity of 84.91% (95% confidence interval (CI) 72.41% –93.25%) to detect positive troponin, 63.74% (52.99–73.56) to detect positive electrocardiogram (ECG) and 71.60% (95% CI 60.5% to 81.07%) to detect final diagnosis of MI. Conclusion: RAQ is a good screening tool to detect MI in the emergency that can be used in isolation or in combination with other diagnostic modalities to detect it early.

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Coronary Artery Disease: An emerging Epidemic in Nepal

Cited by 22 publications

References 3 publications

Prevalence of Coronary Artery Disease in Rheumatic Patients Undergoing Valve Surgeries in Nepal

Prevalence of Coronary Artery Disease in Rheumatic Patients Undergoing Valve Surgeries in Nepal

Cardiovascular Disease Trends in Nepal - An Analysis of Global Burden of Disease Data 2017

Rose Angina Questionnaire: Validation in emergency department to detect myocardial infarction in a tertiary hospital of eastern Nepal

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