TRENDS OF CORONARY ARTERY DISEASE IN KHYBER PAKHTUNKHWA, PAKISTAN: A RETROSPECTIVE STUDY

Main Article Content

Sher Bahadar Khan
Syed Abid Habib
Muhammad Saad Jibran
Ihsan Ali

Abstract

OBJECTIVE: To determine the frequency of new coronary artery disease (CAD) cases during the years 2015, 2016 and 2017 in patients presenting to a cardiology clinic and to look for its current trends in Khyber Pakhtunkhwa (KP), Pakistan.
METHODS: This descriptive study was conducted in a private clinic of interventional cardiologist, based in Lady Reading Hospital, Peshawar, Pakistan from January to March 2018. We retrospectively analyzed the echocardiography data and review of clinical records from January 2015 to December 2017 and identified cases of incident CAD based on Regional Wall Motion Abnormalities on echo. SPSS V20.0 was used for analysis. We applied the unpaired t-test to look for an increasing trend in CAD between 2015-2016, 2016-2017 and 2015 through 2017.
RESULTS: A total of 3865 patients of incident coronary artery disease were identified from January 2015 to December 2017. The number of incident CAD patients was 998 in 2015, 1362 in 2016 and 1505 in 2017. We applied the unpaired t-test on the number of post myocardial infarction patients for an increasing trend in 2015 vs 2016, 2016 vs 2017 and 2015 vs 2017 which showed a p-value of <0.001, 0.961 and <0.001 respectively.
CONCLUSION: CAD is on the rise in KP over the past 3 years and attention needs to be paid to risk factor control and health education in addition to improvement in the health system to prevent this trend from getting out of control among the population of KP.

Article Details

How to Cite
Khan, S. B., S. A. Habib, M. S. Jibran, and I. Ali. “TRENDS OF CORONARY ARTERY DISEASE IN KHYBER PAKHTUNKHWA, PAKISTAN: A RETROSPECTIVE STUDY”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 11, no. 4, Dec. 2019, pp. 214-7, doi:10.35845/kmuj.2019.18507.
Section
Original Articles
Author Biographies

Sher Bahadar Khan, Cardiology Unit, Medical Teaching Institute Lady Reading Hospital, Peshawar, Pakistan

ASSOCIATE PROFESSOR,

Cardiology Unit,

Lady Reading Hospital,

Peshawar.

Syed Abid Habib, Cardiology Unit, Medical Teaching Institute Lady Reading Hospital, Peshawar, Pakistan

Post graduate Resident,

Cardiology Unit,

Lady Reading Hospital,

Peshawar

Muhammad Saad Jibran, Cardiology Unit, Medical Teaching Institute Lady Reading Hospital, Peshawar, Pakistan

Post Graduate Resident,

Cardiology Unit,

Lady Reading Hospital,

Peshawar.

Ihsan Ali, Cardiology Unit, Medical Teaching Institute Lady Reading Hospital, Peshawar, Pakistan

Post Graduate Resident,

Cardiology Unit,

Lady Reading Hospital,

Peshawar.

References

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012 Dec 15;380(9859):2095-128. DOI: 10.1016/S0140-6736(12)61728-0.

Leeder S, Raymond S, Greenberg H, Liu H, Esson K. A race against time: the challenge of cardiovascular disease in developing economies. New York: Trustees of Columbia University 2004. [Cited on: July 11, 2018]. Available from URL: https://www.earth.columbia.edu/news/2004/images/raceagainsttime_FINAL_051104.pdf.

Shepard D, Vande-Zanden A, Moran A, Naghavi M, Murray C, Roth G. Ischemic heart disease worldwide, 1990 to 2013: estimates from the global burden of disease study 2013.Circ Cardiovasc Qual Outcomes 2015 Jul 1;8(4):455-6. DOI: 10.1161/CIRCOUTCOMES.115.002007.

Kim AS, Johnston SC. Global variation in the relative burden of stroke and ischemic heart disease. Circulation 2011 Jul 19;124(3):314-23. DOI: 10.1161/CIRCULATIONAHA.111.018820.

Yakoob MY, Micha R, Khatibzadeh S, Singh GM, Shi P, Ahsan H, et al. Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia: Analysis from the 2010 global burden of disease study. Am J Public Health 2016 Dec;106(12):2113-25. DOI: 10.2105/AJPH.2016.303368.

Moran AE, Tzong KY, Forouzanfar MH, Roth GA, Mensah GA, Ezzati M, et al. Variations in ischemic heart disease burden by age, country, and income: the Global Burden of Diseases, Injuries, and Risk Factors 2010 study. Glob Heart 2014 Mar 1;9(1):91-9. DOI: 10.1016/j.gheart.2013.12.007

Moran AE, Forouzanfar MH, Flaxman AD, Roth G, Mensah G, Ezzati M, et al. Temporal trends in ischemic heart disease mortality in 21 world regions, 1980-2010: The global burden of disease 2010 study. J Am Coll Cardiol 2010;61(10 Supplement):E1407. DOI: 10.1016/S0735-1097(13)61407-2.

Tunstall-Pedoe H, Vanuzzo D, Hobbs M, Mähönen M, Cepaitis Z, Kuulasmaa K, et al. WHO MONICA Project. Estimation of contribution of changes in coronary care to improving survival, event rates, and coronary heart disease mortality across the WHO MONICA Project populations. Lancet 2000 Feb 26;355(9205):688-700. DOI: 10.1016/S0140-6736(99)11181-4.

Kuulasmaa K, Tunstall-Pedoe H, Dobson A, Fortmann S, Sans S, Tolonen H, et al. Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project populations. The Lancet 2000 Feb 26;355(9205):675-87. DOI: 10.1016/S0140-6736(99)11180-2.

Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, et al. Explaining the decrease in US deaths from coronary disease, 1980–2000. N Engl J Med 2007 Jun 7;356(23):2388-98. DOI: 10.1056/NEJMsa053935.

Di-Cesare M, Bennett JE, Best N, Stevens GA, Danaei G, Ezzati M. The contributions of risk factor trends to cardiometabolic mortality decline in 26 industrialized countries. Int J Epidemiol 2013 Jun 1;42(3):838-48. DOI: 10.1093/ije/dyt063.

Jafar TH, Gandhi M, Naheed A, Jehan I, De Silva HA, Finkelstein E, et al. P6256 Large cardiovascular risk burden in rural Bangladesh, Pakistan, and Sri Lanka: design and preliminary findings in a Cluster Randomized Controlled Trial (COBRA-BPS). Eur Heart J 2017 Aug 1;38(suppl_1):ehx493.P6256. DOI: 10.1093/eurheartj/ehx493.P6256.

Huffman MD, Rao KD, Pichon-Riviere A, Zhao D, Harikrishnan S, Ramaiya K, et al. A cross-sectional study of the microeconomic impact of cardiovascular disease hospitalization in four low-and middle-income countries. PLoS One 2011 Jun 14;6(6):e20821. DOI: 10.1371/journal.pone.0020821.

Reddy KS. Cardiovascular disease in non-Western countries. N Engl J Med 2004 Jun 10;350(24):2438-40. DOI:10.1056/NEJMp048024.

Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev 2012 Jan;70(1):3-21. DOI: 10.1111/j.1753-4887.2011.00456.x.

Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K, et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA 2007 Jan 17;297(3):286-94. DOI: 10.1001/jama.297.3.286.

Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet 2011 Jul 2;378(9785):31-40. DOI: 10.1016/S0140-6736(11)60679-X.

Yamamoto SS, Phalkey R, Malik AA. A systematic review of air pollution as a risk factor for cardiovascular disease in South Asia: limited evidence from India and Pakistan. Int J Hyg Environ Health 2014 Mar 1;217(2-3):133-44. DOI: 10.1016/j.ijheh.2013.08.003.

Jibran MS, Zahid ZU, Shawana, Gul AM, Khan SB, Irfan M. Association of nonalcoholic fatty liver disease with coronary artery disease. Pak Heart J 2017;50(04):248-52.