학술논문
Metabolic risk factors in first acute coronary syndrome (MERIFACS) Study.
Document Type
Academic Journal
Author
Hygriv Rao B; Department of Cardiology, KIMS Hospitals, Hyderabad, India; KIMS Foundation and Research Centre (KFRC), Hyderabad, India; Arrhythmia Research & Training Society, Hyderabad, India. Electronic address: hygriv@hotmail.com.; Rama Raju NS; Department of Cardiology, KIMS Hospitals, Rajahmundry, India.; Srinivasa Raju CS; Department of Cardiology, KIMS Hospitals, Nellore, India.; Patel P; Department of Cardiology, Bhandari Hospital, Jabalapur, India.; Korabathina R; KIMS Foundation and Research Centre (KFRC), Hyderabad, India.; Raj JP; Department of Clinical Pharmacology, Seth GS Medical college and KEM Hospitals, Mumbai, India.; Azam MS; Department of Cardiology, KIMS Hospitals, Hyderabad, India.; Annaji Rao B; Department of Cardiology, KIMS Hospitals, Srikakulam, India.; Shivakumar Y; Department of Cardiology, KIMS Hospitals, Hyderabad, India; Department of Cardiology, Mahavir Hospital, Hyderabad.; Abdullakutty J; Department of Cardiology, Lisie Hospital, Kochi.; Krishnam Raju P; Department of Cardiology, CARE Hospital, Banjara Hills, Hyderabad, India.
Source
Publisher: Elsevier Country of Publication: India NLM ID: 0374675 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-3763 (Electronic) Linking ISSN: 00194832 NLM ISO Abbreviation: Indian Heart J Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: In acute coronary syndrome (ACS) patients the focus is on major conventional risk factors - CRF [diabetes, hypertension, elevated low-density cholesterol (LDL-C) and smoking] whereas others - specific metabolic risk factors - MRF [high-density lipoprotein cholesterol (HDL-C), body-mass index (BMI), waist-hip ratio (WHR), and triglycerides, and HbA1c get less attention.
Methods: This is a prospective case-control observational study from 15 tertiary care hospitals in India. CRF and MRF in patients presenting with first incidence of ACS (n = 2153) were compared with matched controls (n = 1210).
Results: Propensity score matching (PSM) yielded 1193 cases and matched 1210 controls. Risk factor prevalence in cases vs. controls were CRF: hypertension - 39.4% vs 16.4% (p < 0.0001), diabetes - 42.6% vs 12.7% (p < 0.0001), smoking - 28.3% vs 9.3% (p < 0.0001) and elevated LDL-C - 70.2% vs 57.9% (p < 0.0001). MRF: High BMI - 54.7% vs 55.1% (p = 0.84), increased waist: hip ratio 79.5% vs 63.6% (p < 0.0001), high HbA1c - 37.8% vs 14.9% (p < 0.0001), low HDL-C - 56.2% vs 42.8% (p < 0.0001) and elevated triglycerides - 49.7% vs 44.2% (p = 0.007). Adjusted Odds ratios by multivariate analysis were CRF: hypertension - 2.3 (p < 0.001), diabetes - 4.7 (p < 0.001), high LDL-C - 3.3 (p < 0.001) and smoking- 6.3 (p < 0.001). MRF: High waist: hip ratio - 2.4 (p < 0.001) high HbA1c - 3.2 (p < 0.001), low HDL-C 2.2 (p < 0.001) and elevated triglycerides - 0.878 p = 0.17.
Conclusion: In India, the risk of ACS conferred by specific metabolic risk factors (High waist: hip ratio, Low HDL-C and High HbA1c) is comparable to that caused by CRF.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved.)
Methods: This is a prospective case-control observational study from 15 tertiary care hospitals in India. CRF and MRF in patients presenting with first incidence of ACS (n = 2153) were compared with matched controls (n = 1210).
Results: Propensity score matching (PSM) yielded 1193 cases and matched 1210 controls. Risk factor prevalence in cases vs. controls were CRF: hypertension - 39.4% vs 16.4% (p < 0.0001), diabetes - 42.6% vs 12.7% (p < 0.0001), smoking - 28.3% vs 9.3% (p < 0.0001) and elevated LDL-C - 70.2% vs 57.9% (p < 0.0001). MRF: High BMI - 54.7% vs 55.1% (p = 0.84), increased waist: hip ratio 79.5% vs 63.6% (p < 0.0001), high HbA1c - 37.8% vs 14.9% (p < 0.0001), low HDL-C - 56.2% vs 42.8% (p < 0.0001) and elevated triglycerides - 49.7% vs 44.2% (p = 0.007). Adjusted Odds ratios by multivariate analysis were CRF: hypertension - 2.3 (p < 0.001), diabetes - 4.7 (p < 0.001), high LDL-C - 3.3 (p < 0.001) and smoking- 6.3 (p < 0.001). MRF: High waist: hip ratio - 2.4 (p < 0.001) high HbA1c - 3.2 (p < 0.001), low HDL-C 2.2 (p < 0.001) and elevated triglycerides - 0.878 p = 0.17.
Conclusion: In India, the risk of ACS conferred by specific metabolic risk factors (High waist: hip ratio, Low HDL-C and High HbA1c) is comparable to that caused by CRF.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved.)