Risk Factors and Demographic profile in Acute Myocardial Infarction: A Prospective Study from Tertiary Care Rural Hospital in North India

Abstract

Introduction: Atherosclerosis is a multi-factorial disease involving the interplay of genetic and environmental factors. Cardiovascular disease (CVD) is rising in low income countries. Studies conducted to assess the prevalence of cardiovascular risk factors among different regions of the country show variation in different age groups of urban and rural population. Current research aimed to study the conventional risk factors in patients of acute myocardial infarction (AMI) presenting in a rural tertiary care hospital in Northern India. Material and Methods: In this cross sectional prospective study, 100 consecutive subjects of first episode of myocardial infarction were enrolled. All patients enrolled in the study were assessed clinically and detailed history with special emphasis on conventional risk factors was taken. Patients were also subjected to investigations like serial electrocardiogram, Echocardiography and biochemical test. Stress evaluation was done using the prevalidated stress scoring system. Physical activity scoring was done with the help of physical activity index. Results: In this study, male comprised of 72% from study population, while, 70% of patients belong to rural population. 46% of study subjects were either labor or farmer by occupation. 34% and 66% of the subjects were less than 45 years and more than 45 years of age respectively. Mean age 54.64 (range: 35-85 years). Smoking (66%) was the commonest conventional risk factor to be present in our study population followed by sedentary lifestyle (50%) and excessive alcohol (44%). Hypertension (HTN) and diabetes mellitus were 28% and 22% respectively. Stress did not appear to be a significant contributor of CAD in our population. The mean high density lipoprotein (HDL) was lower in our study population 35.1 mg/dl ± SD 9.3 (range: 14-55). On univariate analysis, risk factor such as smoking and alcohol was found to be significantly more in younger population (<45 years) as compared to elderly population. When risk factor profile of rural and urban population was compared, no significant difference in the risk factors was found, indicating equal risk of coronary artery disease (CAD) for both rural and urban subjects except lower value of low density lipoprotein (LDL) cholesterol was seen in urban population (p-<0.01). 80% of study population had 5 or >5 conventional risk factors. Conclusion: We conclude, smoking, sedentary lifestyle, uncontrolled diabetes and low HDL levels were the most common conventional risk factors found in the study population especially in younger age group. The present study highlights the need of a better designed, large population based case-control study so as to identify, which amongst the conventional modifiable risk factor is independently responsible for AMI and also highlights the immediate need to initiate measures to raise awareness about control of diabetes, smoking cessation and exercise among the general population especially younger adults.

Secondary Data Analysis of Postmortem Records in PCMC Area to Understand the Burden of Myocardial Infarction

“…A comparative study between the rural and the urban population suffering from cardiovascular diseases in India show that its incidence is more in the urban population than rural by 11%. 5 Even in the month of August 2021, in the times of COVID-19 Pandemic, it was observed that the number of deaths in Pune was more due to Non-communicable disease than from COVID-19. This is indicative of the three fold rise in the incidence of non-communicable diseases in the city.…”

Common Risk Factors of Myocardial Infarction and Some Socio Demographic Characteristics in Sulaimani City

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A study of clinical profile of low risk Acute Coronary syndrome in a teaching tertiary care hospital - A prospective observational study

“…(5) As with the western studies, even the Indian studies point that increasing age is a definite risk factor for developing acute coronary syndromes. (6)(7)(8) It may be construed that younger age group may be taken as significant attribute in the low risk ACS group. Similarly because of the inherent protection provided by estrogen to female and the lower incidence of risk factors (smoking, alcoholism, etc), females are generally at low risk in acute coronary syndromes.…”