Prevalence and risk factors of premature coronary artery disease in patients undergoing coronary angiography in Kurdistan, Iraq
Prevalence and risk factors of premature coronary artery disease in patients undergoing coronary angiography in Kurdistan, Iraq
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DOI：
10.1186/s12872-015-0145-7
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发表时间：
2015-11-18
影响因子：
2.1
通讯作者：
Shaikhow, Sabri Khalif
中科院分区：
文献类型：
--
作者：
Mohammad, Ameen Mosa;Jehangeer, Hekmat Izzat;Shaikhow, Sabri Khalif
背景：早发冠状动脉疾病（PCAD）似乎在增加，特别是在发展中国家。由于缺乏这样的研究在该国，本研究探讨了患病率，相关的心血管危险因素，冠状动脉造影的疾病在Iraq.Methods：数据收集了共445例成年患者在杜胡克心脏中心，库尔德斯坦在2014年3月至9月期间进行冠状动脉造影。结果：经冠状动脉造影证实的PCAD的患病率为31%。PCAD组高脂血症（p = 0.04）、冠状动脉疾病家族史（p = 0.002）、A型病变（p = 0.02）、单支血管病变（p = 0.01）和药物治疗（p = 0.01）的发生率高于MCAD组。Logistic回归模型显示，男性（OR 3.38，C. I 1.96-7.22）、吸烟（OR 2.08）、C. I 1.05-4.12），高血压（OR 1.58，C. I 1.25-2.03）、高脂血症（OR 1.89，C. I 1.17-2.42）和冠心病家族史阳性（OR 2.62，C. I 1.38-9.54）与PCAD相关。敏感性分析显示，冠状动脉狭窄> 70%的患者与冠脉狭窄程度较轻的患者相比，其特异性最高（94.2%），阳性预测值最高（96.5%）。心血管风险因素集中在其中。但PCAD的血管造影特征和治疗选择与以前的研究报告接近。
Background: Premature coronary artery disease (PCAD) seems to increase, particularly in developing countries. Given the lack of such studies in the country, this study examines the prevalence, associated cardiovascular risk factors, and coronary angiographic profile of the disease in Iraq.Methods: Data was collected from a total of 445 adult patients undergoing coronary angiography at Duhok Heart Center, Kurdistan in a period between March and September 2014. Patients were divided into PCAD (male < 45 years and female < 55 years) and mature coronary artery disease (MCAD).Results: The prevalence of the angiographically documented PCAD was 31 %. The PCAD had higher rates of hyperlipidemia (p = 0.04), positive family history of coronary artery disease (p = 0.002), type A lesions (p = 0.02), single vessel disease (p = 0.01) and medical treatment (p = 0.01) than the MCAD. Logistic regression model indicated that male sex (OR 3.38, C. I 1.96-7.22), smoking (OR 2.08, C. I 1.05-4.12), hypertension (OR 1.58, C. I 1.25-2.03), hyperlipidemia (OR 1.89, C. I 1.17-2.42) and positive family history of coronary artery disease (OR 2.62, C. I 1.38-9.54) were associated with the PCAD. Sensitivity analysis showed highest specificity (94.2 %) and positive predictive value (96.5 %) in patients with coronary stenosis > 70 % compared to lesser obstruction.Conclusions: Premature coronary artery disease is alarming in the country. Cardiovascular risk factors are clustered among them. But the angiographic profile and therapeutic options of PCAD are close to those reported from previous studies.