Ethnicity of Symptomatic Coronary Artery Disease Referred for Coronary Angiography in the Galilee: Prevalence, Risk Factors, and a Case for Screening and Modification

Isr Med Assoc J. 2018 Mar;20(3):182-185.

Abstract

Background: Coronary artery disease (CAD) has known risk factors. Individual risks related to specific ethnicities are complex and depend on genetic predisposition and lifestyle.

Objectives: To compare the nature and prevalence of risk factors in Arab and non-Arab ethnic patients with symptomatic obstructive CAD referred for coronary angiography.

Methods: CAD, defined as coronary angiography with a ≥ 50% narrowing in ≥ 1 vessel, was diagnosed in 1029 patients admitted to a medical center between April 2014 and October 2015. Patients were divided into two groups according to ethnic origin: Arab vs. non-Arab. Demographics, clinical presentation, and coronary risk profiles were compared.

Results: The diagnosis of CAD was made during ST-elevation myocardial infarction (STEMI) in 198 patients (19%) who arrived at the clinic, 620 (60%) with unstable angina/non-STEMI, and 211 (21%) with stable angina. Patients with symptomatic CAD and Arab ethnicity were 47% more prevalent than non-Arab patients presenting with CAD. The Arab patients were appoximately 5 years younger, 50% more likely to be active smokers, 25% more likely to be obese, and more likely to have a family history of CAD. Other coronary risk factors were similar between the two groups.

Conclusions: Smoking and obesity, which are potentially modifiable CAD risk factors, stood out as major risk factors, in addition to genetic disposition, among Arab and non-Arab patients with symptomatic CAD. Screening and educational interventions for smoking cessation, obesity control, and compliance to treatment of co-morbidities should be attempted in order to decrease CAD in the Arab population.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Angina, Stable / diagnostic imaging
  • Angina, Stable / epidemiology
  • Angina, Stable / ethnology
  • Angina, Unstable / diagnostic imaging
  • Angina, Unstable / epidemiology
  • Angina, Unstable / ethnology
  • Arabs / statistics & numerical data*
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / ethnology
  • Ethnicity / statistics & numerical data
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Israel / epidemiology
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Obesity / epidemiology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • ST Elevation Myocardial Infarction / diagnostic imaging
  • ST Elevation Myocardial Infarction / epidemiology*
  • ST Elevation Myocardial Infarction / ethnology
  • Smoking / epidemiology