A Case – Control Study of Risk Factors for Coronary Artery Disease in Pakistani Females

Abstract

Objectives: To establish the strength of association of conventional risk factors for coronary artery disease in native Pakistani females.
Methods: We conducted a case – control hospital based study on 198 females (age 30 – 80 years) scheduled for their first coronary angiography at Punjab Institute of Cardiology, Lahore. Patients were divided into pre-menopausal group (age: 45.1 ± 6.3) and post-menopausal group (62.1 ± 9.1). For each risk factor, patients with significant CAD (≥ 50% luminal diameter stenosis) were regarded as cases an those without significant CAD were taken as controls. Odds Ratios (OR) and their 95% confidence intervals (CI) were calculated by univariate analysis.
Results: In total study cohort, Diabetes mellitus (OR 3.65 95% CI 2.0 – 6.5), Family history of premature coronary artery disease (OR 2.3, 95% CI 1.2 – 4.4), and increased waist circumference (OR 2.11, 95% CI 1.2 – 3.8) were strongly associated with significant CAD. In post menopausal age group, diabetes mellitus (OR 2.66 CI 1.3 – 5.1), hyperlipedemia (OR 2.25 CI 1.2 – 2.3) and increased waist circumference (OR 2.16 CI 1.1 – 4.2) reached statistical significance. In pre-menopausal females only diabetes was strongly associated with significant coronary artery disease (OR 10 CI 2.6 – 37.4). Association of hypertension was not significant in any of subgroups studied. Very few cases of smoking (6 / 198) were found in our study to merit any further statistical analysis.
Conclusions: Diabetes mellitus was the only risk factor in pre-menopausal females associated with coronary artery disease While diabetes, hyperlipedemia and increased waist circumference were significantly associated with CAD in post-meno-pausal females.
Key words: Coronary risk factors; pre-menopausal females, post-menopausal females, case control study.
Abbreviations: CAD: coronary artery disease; OR: Odds Ratio; CI: Confidence Intervals, CABG: coronary artery bypass grafting: QCA: Quantitative coronary angiography.