Document Type : Original Article(s)
Authors
- Heidar Dadkhah-Tirani 1
- Tolou Hasandokht 1
- Piergiuseppe Agostoni 2
- Arsalan Salari 3
- Bijan Shad 3
- Soheil Soltanipour 4
1 Assistant Professor, Cardiovascular Diseases Research Center AND Department of Cardiology, School of Medicine, Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
2 Professor, Centro Cardiologico Monzino IRCCS AND Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milano, Italy
3 Associate Professor, Cardiovascular Diseases Research Center, Department of Cardiology AND Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
4 Associate Professor, Department of Community Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Abstract
BACKGROUND: There has been a change in the risk factor profile of patients with coronary artery disease (CAD) in the western world. We sought to compare the risk factor profile of patients undergoing coronary artery bypass graft (CABG) surgery in northern part of Iran in 2010 and 2016.METHODS: In a cross-sectional study, medical records of 296 CABG patients in 2010 and 500 patients in 2016 were collected from a referral university hospital in Guilan province, Iran. We compared the risk factor profile using chi-square test or independent t-test as needed in the two time points, 2010 and 2016.RESULTS: The age of CABG patients significantly decreased from 62.49 ± 8.05 to 58.09 ± 9.20 over time. The frequency of hypertension (HTN) (66.2% vs. 59.1%, P = 0.045), diabetes mellitus (DM) (51.8% vs. 43.6%, P = 0.025), smoking (35.6% vs. 28.0%, P = 0.028), and patients with multimorbidity (31.8% vs. 26.7%, P = 0.001) increased in the second period compared to the first period of study. Whereas, the prevalence of hypercholesterolemia and positive family history of coronary heart disease (CHD) remained stable over time (49.6% vs. 49.0%, P = 0.870; 10.5% vs. 11.1%, P = 0.810, respectively).CONCLUSION: We observed a dramatic increase in DM, HTN, and cigarette smoking as well as the multimorbidity prevalence in 2016 compared to 2010. Even with considering all study limitations, primary and secondary prevention program to decrease cardiovascular disease is required.
Keywords
- McAloon CJ, Boylan LM, Hamborg T, Stallard N, Osman F, Lim PB, et al. The changing face of cardiovascular disease 2000-2012: An analysis of the world health organisation global health estimates data. Int J Cardiol 2016; 224: 256-64.
- Puska P, Norrving B. Global Atlas on Cardiovascular Disease Prevention and Control. Geneva, Swizerland: World Health Organization; 2011.
- Laslett LJ, Alagona P Jr, Clark BA 3rd, Drozda JP Jr, Saldivar F, Wilson SR, et al. The worldwide environment of cardiovascular disease: Prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology. J Am Coll Cardiol 2012; 60(25 Suppl): S1-49.
- Naghavi M, Shahraz S, Sepanlou SG, Dicker D, Naghavi P, Pourmalek F, et al. Health transition in Iran toward chronic diseases based on results of Global Burden of Disease 2010. Arch Iran Med 2014; 17(5): 321-35.
- Forouzanfar MH, Sepanlou SG, Shahraz S, Dicker
- D, Naghavi P, Pourmalek F, et al. Evaluating causes of death and morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010. Arch Iran Med 2014; 17(5): 304-20.
- Sadeghi M, Haghdoost AA, Bahrampour A, Dehghani M. Modeling the burden of cardiovascular diseases in Iran from 2005 to 2025: The impact of demographic changes. Iran J Public Health 2017; 46(4): 506-16.
- Hosseini-Esfahani F, Mousavi Nasl Khameneh A, Mirmiran P, Ghanbarian A, Azizi F. Trends in risk factors for cardiovascular disease among Iranian adolescents: The Tehran Lipid and Glucose Study, 1999-2008. J Epidemiol 2011; 21(5): 319-28.
- Moradi-Lakeh M, Forouzanfar MH, El Bcheraoui C, Daoud F, Afshin A, Hanson SW, et al. High fasting plasma glucose, diabetes, and its risk factors in the eastern Mediterranean region, 1990-2013: Findings from the global burden of disease study 2013. Diabetes Care 2017; 40(1): 22-9.
- Kelishadi R, Heshmat R, Farzadfar F, Esmaeil Motlag M, Bahreynian M, Safiri S, et al. Prevalence of cardio-metabolic risk factors in a nationally representative sample of Iranian adolescents: The Caspian-III Study. J Cardiovasc Thorac Res 2017; 9(1): 12-20.
- Foguet-Boreu Q, Violan C, Roso-Llorach A, Rodriguez-Blanco T, Pons-Vigues M, Munoz-Perez MA, et al. Impact of multimorbidity: Acute morbidity, area of residency and use of health services across the life span in a region of south Europe. BMC Fam Pract 2014; 15: 55.
- Gijsen R, Hoeymans N, Schellevis FG, Ruwaard D, Satariano WA, van den Bos GA. Causes and consequences of comorbidity: A review. J Clin Epidemiol 2001; 54(7): 661-74.
- Kasteridis P, Street AD, Dolman M, Gallier L, Hudson K, Martin J, et al. The importance of multimorbidity in explaining utilisation and costs across health and social care settings: Evidence from South Somerset's Symphony Project. York, UK: Centre for Health Economics, University of York; 2014.
- Ahmadi B, Alimohammadian M, Yaseri M, Majidi A, Boreiri M, Islami F, et al. Multimorbidity: Epidemiology and risk factors in the Golestan Cohort Study, Iran: A cross-sectional analysis. Medicine (Baltimore) 2016; 95(7): e2756.
- Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA. Multimorbidity prevalence and patterns across socioeconomic determinants: A cross-sectional survey. BMC Public Health 2012; 12: 201.
- Poddar KL, Modi DK, Wayangankar S, Thakkar B, Krishnaswamy A, Kumari M, et al. Two-decade trends in the prevalence of atherosclerotic risk factors, coronary plaque morphology, and outcomes in adults aged
- ElBardissi AW, Aranki SF, Sheng S, O'Brien SM, Greenberg CC, Gammie JS. Trends in isolated coronary artery bypass grafting: An analysis of the Society of Thoracic Surgeons adult cardiac surgery database. J Thorac Cardiovasc Surg 2012; 143(2): 273-81.
- Kindo M, Hoang MT, Perrier S, Bentz J, Mommerot A, Billaud P, et al. Trends in isolated coronary artery bypass grafting over the last decade. Interact Cardiovasc Thorac Surg 2017; 24(1): 71-6.
- Mandegar M, Marzban M, Lebaschi A, Ghaboussi P, Alai-Alamooti A, Ardalan A. Cardiovascular risk factors and in-hospital mortality in 1258 cases of coronary artery bypass surgery in Tehran heart center. Acta Med Iran 2008; 46(5): 386-90.
- Lopez-de-Andres A, Jimenez-Garcia R, Hernandez-Barrera V, Perez-Farinos N, de Miguel-Yanes JM, Mendez-Bailon M, et al. National trends in utilization and outcomes of coronary revascularization procedures among people with and without type 2 diabetes in Spain (2001-2011). Cardiovasc Diabetol 2014; 13: 3.
- Fryar CD, Chen TC, Li X. Prevalence of uncontrolled risk factors for cardiovascular disease: United States, 1999-2010. NCHS Data Brief 2012; (103): 1-8.
- Khosravi-Boroujeni H, Sarrafzadegan N, Sadeghi M, Roohafza H, Talaei M, Ng SK, et al. Secular Trend of Metabolic Syndrome and Its Components in a Cohort of Iranian Adults from 2001 to 2013. Metab Syndr Relat Disord 2017; 15(3): 137-44.
- Etemadi A, Khademi H, Kamangar F, Freedman ND, Abnet CC, Brennan P, et al. Hazards of cigarettes, smokeless tobacco and waterpipe in a Middle Eastern Population: A Cohort Study of 50 000 individuals from Iran. Tob Control 2017; 26(6): 674-82.
- Salloum RG, Thrasher JF, Getz KR, Barnett TE, Asfar T, Maziak W. Patterns of waterpipe tobacco smoking among U.S. young adults, 2013-2014. Am J Prev Med 2017; 52(4): 507-12.
- Sibai AM, Tohme RA, Almedawar MM, Itani T, Yassine SI, Nohra EA, et al. Lifetime cumulative exposure to waterpipe smoking is associated with coronary artery disease. Atherosclerosis 2014; 234(2): 454-60.
- Thorsteinsson K, Fonager K, Merie C, Gislason G, Kober L, Torp-Pedersen C, et al. Age-dependent trends in postoperative mortality and preoperative comorbidity in isolated coronary artery bypass surgery: A nationwide study. Eur J Cardiothorac Surg 2016; 49(2): 391-7.
- Nielsen S, Bjorck L, Jeppsson A, Giang KW, Falk K, Maatta S, et al. Trends in mortality risks among 94,328 patients surviving 30days after a first isolated coronary artery bypass graft procedure from 1987 to 2006: A population-based study. Int J Cardiol 2017; 244: 316-21.
- Bagheri LK, Ghahramani S, Honarvar B. A study on hospitalized patients' payment in south of Iran after the first round of health sector reform. Iran J Public Health 2017; 46(2): 276-7.
- Ko W, Tranbaugh R, Marmur JD, Supino PG, Borer JS. Myocardial revascularization in New York State: Variations in the PCI-to-CABG ratio and their implications. J Am Heart Assoc 2012; 1(2): e001446.
- Vaez M, Dalen M, Friberg O, Nilsson J, Frobert O, Lagerqvist B, et al. Regional differences in coronary revascularization procedures and outcomes: A nationwide 11-year observational study. Eur Heart J Qual Care Clin Outcomes 2017; 3(3): 243-8.
- Sajadi HS, Zaboli R. An assessment of the positive effects of health reform plan implementation from the perspective of hospital directors. Health Inf Manage 2016; 13(1): 55-60.
)