Cardiometabolic risk factors associated with coronary artery disease in Asian Indian population

Abstract

Coronary artery disease (CAD) has become a leading cause of mortality in both developed and developing countries. The present study was intended to explore the metabolic risk factors associated with high prevalence of CAD in Asian Indians. We recruited 1375 human subjects (660 angiographically confirmed CAD patients and 715 healthy controls) aged 25-85 years from north India. Standard anthropometric, socioeconomic and quantitative measurements were done in all the participants. Alcohol consumption and smoking emerged as a major risk factor for developing CAD (Odd ratio; 2.9 (2.22-3.89) p≤0.000 and 5.2 (3.34-8.09) p=0.000) respectively. The physical activity was significantly lower in CAD patients than controls. CAD patients had marked abdominal adiposity as reflected by their significantly higher Waist to Hip Ratio (WHR) and waist circumference. Also significantly higher body fat (%) was observed in women CAD patients (43.8±5.9) than their male counterparts (26.9±6.1). The reduced HDL-cholesterol and elevated creatinine values observed in CAD patients may have contributed to the pathophysiology of CAD and renal dysfunctioning in this study. The atherogenic indices i.e. TC/HDL ratio and the LDL/HDL ratios significantly predicted the primary cardiovascular risk in control subjects. In conclusion, the present study established low socioeconomic status, unhealthy diet and sedentary lifestyle, abdominal obesity, high alcohol consumption and smoking and dyslipidemia emerged as the metabolic risk factors contributing to the pathophysiology of CAD in Asian Indians. Large studies are necessary to determine the genetic predisposition in the pathogenesis of CAD in this population.