Metabolic Syndrome and Coronary Artery Disease in Indians Younger Than 40 Years

Background: Indians have highest risk rates of coronary artery disease (CAD) amongst all ethnic groups. The impact of metabolic syndrome (MS) has not been studied, especially in the young. This study analyzes the prevalence of metabolic syndrome and its various components in young Indians with CAD. Methods: The study was conducted at a tertiary teaching hospital in New Delhi. A retrospective case record analysis of 403 patients presenting acutely with young (age <= 40 year) CAD during the period Jan 2005 - Dec 2009 was done. The criterion advocated by International Diabetes Federation (IDF) consensus 2005 was used for diagnosing patients with MS. The data was then used to find the prevalence of derangement of various metabolic parameters in all patients and in those with MS. Statistical analysis was done using SPSS v.17. Results: Patients (246) were selected for study. Metabolic syndrome was present in 66 patients (26.8%). In patients with young CAD low HDL was found in 171 (69.5%), raised triglycerides 103 patients (41.9%), hypertension in 55 patients (22.4%) and impaired fasting glucose/diabetes mellitus in 54 patients (21.9%); 187 (75.6%) patients had history of smoking; 64 patients (26.0%) had a family history of young cardiovascular disorders; 13 females out of 28 (46.4%) and 53 males out of 218 (24.3%) met criteria for diagnosis of MS. Prevalence of MS in females was significantly more than males (P < 0.02). Among 66 patients diagnosed with MS, low HDL was seen in 52 patients (78.8%), raised triglycerides in 49 patients (74.2%), hypertension in 36 patients (54.5%) and dysglycemia in 35 patients (53.0%); 47 patients (71.2%) had history of smoking. A positive family history of premature cardiovascular disorders was present in 26 patients (39.4%). Among patients with young CAD, prevalence of smoking was more in males compared to female patients (P < 0.005) whereas hypertension and obesity in were noted more often in female patients (P < 0.005). Conclusions: This study confirms a high prevalence of MS in patients with young CAD. This study also underlies the importance of smoking and dyslipidemia as primary targets for effective prevention of CAD and MS in young Indians.