title: Atherothrombotic risk factors & premature coronary heart disease in India: a case-control study.
abstract: OBJECTIVE
  It was hypothesized that both thrombogenic and atherogenic factors may be responsible for premature coronary heart disease (CHD) in young Indians. A case-control study was performed to determine cardiovascular risk factors in young patients with CHD in India.
  
  
  METHODS
  Successive consenting patients <55 yr with an acute coronary event or recent diagnosis of CHD were enrolled (cases, n=165). Age- and gender-matched subjects with no clinical evidence of CHD were recruited as controls (n=199). Demographic, anthropometric, clinical, haematological, and biochemical data were obtained in both groups. Univariate and multivariate logistic regression were performed to identify important risk factors.
  
  
  RESULTS
  In cases vs. controls mean systolic BP, diastolic BP, platelet counts, LDL cholesterol, non-HDL cholesterol, triglycerides, and fibrinogen were higher and HDL cholesterol lower (P<0.001). The presence of current smoking, low fruit and vegetables intake, high fat intake, hypertension, diabetes, low HDL cholesterol, and high LDL cholesterol, total:HDL ratio, fibrinogen and homocysteine was significantly higher in cases (P<0.05). Multivariate logistic regression analysis (age adjusted odds ratio, 95% confidence intervals) revealed that smoking (19.41, 6.82-55.25), high fat intake (1.66, 1.08-2.56), low fruit and vegetables intake (1.99, 1.11-3.59), hypertension (8.95, 5.42-14.79), high LDL cholesterol [2.49 (1.62-3.84)], low HDL cholesterol (10.32, 6.30-16.91), high triglycerides (3.62, 2.35-5.59) high total:HDL cholesterol (3.87, 2.35-5.59), high fibrinogen (2.87, 1.81-4.55) and high homocysteine (10.54, 3.11-35.78) were significant.
  
  
  CONCLUSIONS
  Our results showed that thrombotic (smoking, low fruit/vegetables intake, fibrinogen, homocysteine) as well as atherosclerotic (hypertension, high fat diet, dyslipidaemia) risk factors were important in premature CHD. Multipronged prevention strategies are needed in young Indian subjects.
authors.affiliation: Department of Cardiology, SP Medical College & Associated Group of Hospitals, Bikaner, India. bkgbkn@rediffmail.com
authors.forename: Raja Babu
authors.initials: RB
authors.lastname: Panwar
authors.forename: Rajeev
authors.initials: R
authors.lastname: Gupta
authors.forename: Bal Kishan
authors.initials: BK
authors.lastname: Gupta
authors.forename: Sadiq
authors.initials: S
authors.lastname: Raja
authors.forename: Jaishree
authors.initials: J
authors.lastname: Vaishnav
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Khatri
authors.forename: Aachu
authors.initials: A
authors.lastname: Agrawal
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000453:epidemiology*; D001794:Blood Pressure; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000453:epidemiology*; D004435:Eating; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007194:India; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013927:Thrombosis / Q000453:epidemiology*; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D006710:Homocysteine; D005340:Fibrinogen