Risk Factors for Acute Myocardial Infarction in Goa, India: A Case Control Study
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 3
Abstract
Introduction: Myocardial infarction is turning to be a significant health problem in India along with other lifestyle diseases. The risk factors identified included sedentary life style, cigarette smoking, hypertension, dyslipidemia and diabetes mellitus. The excess risk of coronary heart disease in Indians appears to be greater at younger ages, while some features and risk factors of coronary heart disease in India are peculiar. The state of Goa boasts of a westernized and urbanized culture is conducive to development of any of the lifestyle diseases. Study objectives were to study certain risk factors associated with acute myocardial infarction in Goa, India Material and methods: A hospital based case-control study was conducted at a tertiary care hospital in Goa, India. Age and sex matched cases and controls (group matching) in the ratio of 1:1 constituted the study sample. Cases of acute myocardial infarction were defined as per the MONICA criteria. Interview was carried at patient’s bedside using a predesigned structured questionnaire. In addition, blood pressure measurements, anthropometric measures, ECG and laboratory investigations were done. Approval for the study was obtained from the Institutional Ethics Committee of the Institute prior to the conduct of the study. Statistical analysis was carried using SPSS software package version 21.0. Statistical tests included odds ratio with 95% confidence interval, chi square test and t test. Multiple logistic regression analysis (step wise forward method) was used to examine the independent effect of different risk factors. Results: Smoking (OR=3.59; 95% CI: 2.25-5.73) and Alcohol use (OR=2.98; 95% CI: 1.8-4.9) were found to be significantly associated with acute myocardial infarction. The risk of developing acute myocardial infarction increased with the number of drinks consumed per day and number of cigarettes smoked per day. Similarly, hypertension (OR=3.3; 95%CI: 2.18-5.0), diabetes mellitus (OR=3.06; 95% CI: 2.0- 4.7), obesity (OR=1.91; 95% CI: 1.18-3.10) and low physical activity (OR=1.81; 95% CI: 0.96-3.42) were also identified as significant risk factors for myocardial infarction. On multiple logistic regression analysis, current smoking, number of cigarettes smoked per day, duration of smoking, frequency of smokeless tobacco per day, number of alcohol drinks per day, hypertension, diabetes mellitus and obesity were identified as significant independent risk factors for acute myocardial infarction. Conclusion: Considering the risk factors identified in the study there is an urgent need to develop policy measures to promote healthy life style habits. Such measures could include risk factor interventions among those with risk factors, health education campaigns for the general public and development of a comprehensive healthcare programme.
Authors and Affiliations
AM Ferreira, S R Shiolkar, FS Vaz, NR Pinto, SG Perni, MS Kulkarni
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