Risk factors of premature coronary artery disease in Iran: A systematic review and meta‐analysis

Abstract

Background The aim of this study was to determine the mean age at which coronary artery disease (CAD) hase decreased in recent years in Iran. This systematic review and meta‐analysis compares the prevalence of different risk factors of premature CAD (PCAD) in patients vs healthy individuals. Methods Medline, Web of Science, Embase and Scientific Information Database were searched for studies about PCAD risk factors in Iran until 28 October 2017. Observational studies of Iranians, comparing risk factors between patients with PCAD and age‐ and sex‐matched healthy subjects, were included. Fixed‐effects and random‐effects model were used for pooling data. Odds ratio (OR) with 95% CI and mean difference were used for effect size estimation among studies. Results Twelve studies were eligible for meta‐analysis. Diabetes mellitus (OR: 2.4, 95% CI: 1.9‐3.03; P = 0.0001, I2 = 25.5%; P = 0.2), family history of CAD (OR: 2.09, 95% CI: 1.22‐3.6; P = 0.007, I2 = 86%; P = 0.0001), dyslipidaemia (OR: 2.05, 95% CI: 1.15‐3.64; P = 0.01, I2 = 54%; P = 0.08), smoking (OR: 1.65, 95% CI: 1.11‐2.46; P = 0.01, I2 = 77.2%; P = 0.000) and hypertension (OR: 1.35, 95% CI: 1.21 to‐1.50; P < 0.001, I2 = 31%, P = 0.1) associated with PCAD. Sensitivity analysis demonstrated that patients with PCAD had significantly lower levels of high‐density lipoprotein (HDL) cholesterol and significantly higher levels of triglycerides compared to healthy subjects (MD: −2.56, 95% CI: −3.54 to −1.58, P < 0.001, I2 = 42%, P = 0.01 and MD: 21.17, 95% CI: 14.73‐27.62, P < 0.001, I2 = 80.12%, P < 0.001, respectively). It should be noted that although high levels of heterogeneity in LDL and HDL values among the studies were observed, when dyslipidaemia was studied as a binary variable, no significant heterogeneity among studies was observed. Conclusion Diabetes mellitus, family history of CAD, dyslipidaemia, smoking, and hypertension were significantly and positively associated with CAD in young adults compared to healthy age‐ and sex‐matched population in Iran.

Effect of ABCA1 promoter methylation on premature coronary artery disease and its relationship with inflammation

“…Despite the continuous improvement in preventive measures and medical technology, coronary artery disease (CAD) remains as the main cause of mortality worldwide [1,2]. Its age of onset is gradually becoming younger, especially in developing countries, and the incidence of premature coronary artery disease (pCAD) is yearly increasing [3,4]. Because pCAD has a long course and poor prognosis, its prevention and treatment is an urgent medical problem that needs to be addressed.…”

“…Because pCAD has a long course and poor prognosis, its prevention and treatment is an urgent medical problem that needs to be addressed. However, the definition of pCAD was not uniformly established, the age cut-off can vary from 45 to 65 years among studies due to the variation in risk factors affecting different populations and ethnicities [3][4][5][6]. Chinese Studies on pCAD commonly used the definition of onset age < 55 years for males and < 65 years for females [7].…”

Identification of Coronary Risk Factors Among Urban and Rural Malaysian Youths and Their Possible Underlying Causes

“…There are multiple risk factors that are associated with progression of early CAD for instance hypertension, obesity, diabetes mellitus (DM), dyslipidaemia, physical inactivity and smoking [7][8][9] . In view of the recent trend of early CAD, prompt and early identi cation of the coronary risk factors (CRF) among adolescents and youths is vital to assist in determining the high-risk group to develop CAD in later life.…”

Relationship of hypomethylation CpG islands in interleukin-6 gene promoter withIL-6mRNA levels in patients with coronary atherosclerosis

“… 2 Recent data suggest that the most common risk factor for the adult Iranian population is atherosclerosis. 3 - 5 The most important health problem in Iran is the high prevalence and mortality rate. 6 , 7 …”