PREVALENCE AND RISK FACTORS OF CORONARY ARTERY DISEASE IN PAKISTAN: A MULTICENTER COHORT STUDY
Main Article Content
Keywords
Coronary artery disease, Pakistan, cardiovascular risk factors, hypertension, diabetes, smoking, obesity, urban-rural disparities, lipid profile, preventive cardiology.
Abstract
Background
Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide, with a disproportionately high burden in South Asian populations, including Pakistan. Lifestyle changes, urbanization, and increasing rates of hypertension, diabetes, obesity, and smoking have contributed to the rising prevalence of CAD. Despite existing research, there is limited multicenter data evaluating the prevalence and risk factors of CAD across different regions of Pakistan.
Objective
This study aimed to determine the prevalence of CAD and identify key demographic, clinical, and lifestyle-related risk factors associated with the disease in a diverse Pakistani population.
Methods
A multicenter, prospective cohort study was conducted at two major cardiology institutions in Pakistan from January 1, 2023, to December 31, 2023. A total of 1,262 adult patients (aged 30–75 years) were enrolled based on clinical suspicion or established CAD diagnosis. Data were collected on demographics, comorbidities, lifestyle habits, and lipid profiles. CAD was defined as ≥50% stenosis in at least one coronary artery, confirmed via angiography. Statistical analyses, including multivariate logistic regression, were performed to identify independent risk factors.
Results
The overall prevalence of CAD was 34.9%, with a higher burden among urban residents (37.2%) compared to rural populations (28.5%) (p = 0.007). Men had a higher CAD prevalence (36.7%) than women (32.4%). Hypertension (OR 1.86, p < 0.001), diabetes (OR 2.14, p < 0.001), smoking (OR 1.52, p = 0.002), and obesity (OR 1.42, p = 0.005) were independently associated with CAD. Patients with multi-vessel disease exhibited significantly higher LDL cholesterol levels (p = 0.013). Nearly 47.3% of patients presented late, with delays more pronounced in rural areas (p = 0.007).
Conclusion
This study highlights a high prevalence of CAD in Pakistan, with significant regional and gender disparities. Hypertension, diabetes, smoking, and obesity remain key modifiable risk factors. Early screening programs, public health interventions, and improved rural healthcare access are necessary to reduce CAD morbidity and mortality. Future studies should explore genetic predispositions and long-term intervention outcomes.
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Dr Muhammad Hasnain
Medical Officer, Shaheed Mohtrama Benazir Bhutto Institute of Trauma and Emergency Response Center, Larkana, Pakistan
Dr Sadaf Yasin
Medical Officer, Shaheed Mohtrama Benazir Bhutto Institute of Trauma and Emergency Response Center, Larkana, Pakistan
Dr Fahad Raja Khan
Fellow Intervention Cardiology, Peshawar Institute of Cardiology, Pakistan
Dr Kamran Aslam
Fellow Intervention Cardiology, Peshawar Institute of Cardiology, Pakistan
Dr Atif Ihsan
Fellow Intervention Cardiology, Peshawar Institute of Cardiology, Pakistan
Dr Nasir Farooq
Fellow Intervention Cardiology, Peshawar Institute of Cardiology, Pakistan