Risk Factor Patterns for Premature Versus Late-Onset Coronary Artery Disease in Iran: A Systematic Review and Meta-Analysis
Negar Morovatdar1, Yones Bondarsahebi2, Nastaran Khorrampazhouh2, Seyyed A. Hozhabrossadati2, Konstantinos Tsarouhas3, Ramin Rezaee1, Reza J. Esfehani4, Hoorak Poorzand5, *, Amirhossein Sahebkar6, 7, 8, *
Identifiers and Pagination:Year: 2019
First Page: 5
Last Page: 12
Publisher Id: TOCMJ-13-5
Article History:Received Date: 29/11/2018
Revision Received Date: 07/01/2019
Acceptance Date: 28/01/2019
Electronic publication date: 26/03/2019
Collection year: 2019
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
There are few data regarding the risk factors of premature vs late-onset Coronary Artery Disease (CAD). This study systematically reviews these risk factors in Iranian people.
Medline, Web of Science, Embase and SID (Scientific Information Database; www.sid.ir) databases were searched for studies comparing CAD risk factors in young and older patients in Iran. Data extracted and pooled odds ratio (OR) with 95% Confidence Interval (CI) for each risk factor were calculated. Publication bias was evaluated by Egger’s test.
Seven studies (9080 participants) were included in the meta-analysis; analysis was carried out independently for each risk factor. Smoking (Odds Ratio (OR): 2.57, 95% CI: 1.96-3.37; p=<0.001), family history of CAD (OR: 2.45: 95% CI, 1.44-4.15, p<0.001), opium abuse (OR: 2.44: 95% CI, 1.22-4.88; p=0.001) and hyperlipidaemia (OR: 1.4: 95% CI, 1.13-1.73; p=0.001) were more common in premature CAD compared with older CAD patients. In contrast, diabetes mellitus (OR: 0.54: 95% CI, 0.39-0.73; p=0.0001) and hypertension (OR: 0.36, 95% CI: 0.21-0.59; p<0.001) were less prevalent.
Risk factors were significantly different between premature and late-onset CAD. Policies regarding smoking and opium cessation and controlling hyperlipidaemia may be useful for the prevention of premature CAD in Iran.