Prevalence and trends of coronary artery disease risk factors and their effect on age of diagnosis in patients with established coronary artery disease: Tehran Heart Center (2005–2015)

Abstract

Background Coronary artery disease (CAD) is a universal public health challenge, more prominently so in the low- and middle-income countries. In this study, we aimed to determine prevalence and trends of CAD risk factors in patients with documented CAD and to determine their effects on the age of CAD diagnosis. Materials and methods We conducted a registry-based, serial cross-sectional study using the coronary angiography data bank of the Tehran Heart Center. Adult patients who had obstructive (> 50% stenosis) CAD were included in the study. The prevalence and 11-year trends of conventional CAD risk factors were analyzed by sex and age, and their adjusted effects on the age of CAD diagnosis were calculated. Results From January 2005 to December 2015, data for 90,094 patients were included in this analysis. A total of 61,684 (68.5%) were men and 28,410 (31.5%) were women. Men were younger at diagnosis than women, with a mean age of 60.1 in men and 63.2 in women (p < 0.001), and had fewer risk factors at the time of diagnosis. Mean age at diagnosis had an overall increasing trend during the study period. Increasing trend was seen in body-mass index, hypertension prevalence, diabetes mellitus. All lipid profile components (total cholesterol, low-density lipoprotein cholesterol, triglycerides, and high-density lipoprotein cholesterol) decreased over time. Of particular interest, opium consumption was associated with 2.2 year earlier age of CAD diagnosis. Conclusion The major results of this study (lower age of CAD diagnosis in men, lower age of diagnosis associated with most risk factors, and lower prevalence of serum lipids over time) were expected. A prominent finding of this study is confirming opium use was associated with a much younger age of CAD onset, even after adjusting for all other risk factors. In addition to recommendations for control of the traditional risk factors, spreading information about the potential adverse effect of opium use, which has only recently been associated with higher risk of CAD, may be necessary.

Machine learning algorithms for predicting mortality after coronary artery bypass grafting

“…Preoperative variables consisted of serum hemoglobin (Hb), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), total cholesterol, triglycerides (TG), creatinine (Cr), left ventricular ejection fraction (EF), diabetes, hypertension, opium consumption, smoking status, prior myocardial infarction (MI), preoperative heart failure (HF), and chronic obstructive pulmonary disease (COPD). The definitions were consistent with prior studies on this population (9). Perioperative variables, including cardiopulmonary pump utilization and ventilation hours, were assessed.…”

The prevalence of coronary atherosclerosis in patients with refractory gastroesophageal reflux disease ready for antireflux surgery

“…The first 4 risk factors have long been reported and proven to be risk factors for CAS. [ 26 , 27 ] Regarding BE with CAS in patients with RGERD, few studies have reported BE alone until now. Our previous study reported that GERD is very common in patients with CAD and refractory chest pain, and 49% of chest pain is associated with acid reflux due to GERD.…”

Comparision of Myocardial Viability Assessment Between Cardiac Magnetic Resonance Imaging and Single Photon Emission Computed Tomography in Patients with Coronary Artery Disease

“…Global incidence of CAD is increasing day by day. 12,13 There are tons of evidence that revascularization can help to return contractile function in presence of viable, ischemic and dysfunction myocardium. Patients with severely reduced LV systolic function but viable myocardium are still candidates of revascularization rather than cardiac transplantation.…”