Socioeconomic Factors and Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography: A Multicentre Study of Arabian Gulf States
| Autor: | Mohamed Nabil Alama, S. Ali Nasseri, Amin Daoulah, Ibrahim Saeed bin Sadan Alzahrani, Amir Lotfi, Salem M. Al-Faifi, Ejazul Haq, Abdullah A. Alghamdi, Mushabab Al-Murayeh, Salem Alkaabi, Osama E. Elkhateeb, Alawi A. Alsheikh-Ali, Waleed Ahmed, Mamdouh Haddara, Adnan Fathey, Ciaran M. Dixon |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Cross sectional study Cross-sectional study Coronary angiography medicine.medical_treatment 030204 cardiovascular system & hematology Coronary artery disease Article 03 medical and health sciences 0302 clinical medicine Internal medicine Epidemiology medicine CAD 030212 general & internal medicine Cause of death medicine.diagnostic_test business.industry Percutaneous coronary intervention medicine.disease Arabian Gulf Stenosis Conventional PCI Angiography Cardiology Cardiac epidemiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Open Cardiovascular Medicine Journal |
| ISSN: | 1874-1924 |
| DOI: | 10.2174/1874192401711010047 |
| Popis: | Introduction:Coronary artery disease (CAD) is a leading cause of death worldwide. The association of socioeconomic status with CAD is supported by numerous epidemiological studies. Whether such factors also impact the number of diseased coronary vessels and its severity is not well established.Materials and Methods:We conducted a prospective multicentre, multi-ethnic, cross sectional observational study of consecutive patients undergoing coronary angiography (CAG) at 5 hospitals in the Kingdom of Saudi Arabia and the United Arab Emirates. Baseline demographics, socioeconomic, and clinical variables were collected for all patients. Significant CAD was defined as ≥70% luminal stenosis in a major epicardial vessel. Left main disease (LMD) was defined as ≥50% stenosis in the left main coronary artery. Multi-vessel disease (MVD) was defined as having >1 significant CAD.Results:Of 1,068 patients (age 59 ± 13, female 28%, diabetes 56%, hypertension 60%, history of CAD 43%), 792 (74%) were from urban and remainder (26%) from rural communities. Patients from rural centres were older (61 ± 12vs58 ± 13), and more likely to have a history of diabetes (63vs54%), hypertension (74vs55%), dyslipidaemia (78vs59%), CAD (50vs41%) and percutaneous coronary intervention (PCI) (27vs21%). The two groups differed significantly in terms of income level, employment status and indication for angiography. After adjusting for baseline differences, patients living in a rural area were more likely to have significant CAD (adjusted OR 2.40 [1.47, 3.97]), MVD (adjusted OR 1.76 [1.18, 2.63]) and LMD (adjusted OR 1.71 [1.04, 2.82]). Higher income was also associated with a higher risk for significant CAD (adjusted OR 6.97 [2.30, 21.09]) and MVD (adjusted OR 2.49 [1.11, 5.56]), while unemployment was associated with a higher risk of significant CAD (adjusted OR 2.21, [1.27, 3.85]).Conclusion:Communal and socioeconomic factors are associated with higher odds of significant CAD and MVD in the group of patients referred for CAG. The underpinnings of these associations (e.g.pathophysiologic factors, access to care, and system-wide determinants of quality) require further study. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|