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Is coronary heart disease rising in India? A systematic review based on ECG defined coronary heart disease.

ABSTRACT: The aim of this study was to investigate whether coronary heart disease (CHD) is rising in India and assess the quality of the evidence. Thirty one studies were reviewed. The sample sizes of the studies varied from approximately 500 to 14,000, with response rates generally over 90%. Many did not fulfil basic requirements for epidemiological research and most studies were in or around Delhi. The three incidence studies used different diagnostic criteria; however, the incidence of myocardial infarction (MI) in urban India in the 14 years to 1991 remained similar at about 6/1000 in males and 2/1000 in females. Prevalence range was higher in urban than rural areas in men (35-90/1000 v 17-45/1000) and women (28-93/1000 v 13-43/1000). There was no clear rise in age specific rates in men over a 27 year period, whereas a rise was seen in women. In conclusion, using a relatively objective measure of CHD it was found that CHD is more common in urban than rural areas of India, but there was little evidence of a rise in CHD over time, especially in men.

SUBMITTER: Ahmad N

PROVIDER: S-EPMC1768945 | biostudies-literature | 2005 Jun

REPOSITORIES: biostudies-literature

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Is coronary heart disease rising in India? A systematic review based on ECG defined coronary heart disease.

Ahmad N N Bhopal R R

Heart (British Cardiac Society) 20050601 6

The aim of this study was to investigate whether coronary heart disease (CHD) is rising in India and assess the quality of the evidence. Thirty one studies were reviewed. The sample sizes of the studies varied from approximately 500 to 14,000, with response rates generally over 90%. Many did not fulfil basic requirements for epidemiological research and most studies were in or around Delhi. The three incidence studies used different diagnostic criteria; however, the incidence of myocardial infar ...[more]

PMID: 15894760

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Project description:Background: Anti-inflammatory therapy has been proposed as a promising treatment for coronary heart disease (CHD) that could reduce residual inflammation risk (RIR) and therefore major adverse cardiovascular events. We implemented a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the clinical benefits of anti-inflammatory agents in patients with CHD based on secondary cardiovascular prevention. Methods: We systemically searched the PubMed, Embase, and Cochrane Library databases for RCTs (published between Jan 1, 1950, and June 1, 2021; no language restrictions) that focused on anti-inflammatory therapy for coronary heart disease. Our primary end points of interest were a composite of all-cause death, recurrent myocardial infarction and stroke. We processed pooled data using a random-effects model. Results: Of 1497 selected studies, 18 studies with 67,449 participants met our inclusion criteria and were included in the present meta-analysis. Comparing anti-inflammatory agents with placebo, there was no significant decrease in risk of primary end points, secondary end points, all-cause mortality, cardiac mortality, recurrent myocardial infarction, stroke or revascularization. Further subgroup analysis indicated that anti-inflammatory agents led to a significant reduction in secondary end points (OR 0.87, CI 0.77-0.99; P = 0.03), recurrent myocardial infarction (OR 0.86, CI 0.78-0.95; P = 0.003) and revascularization (OR 0.81, CI 0.70-0.92; P = 0.001) in patients with stable CHD compared with placebo. Moreover, stable CHD patients had a lower propensity for recurrent myocardial infarction than acute coronary syndrome (ACS) patients when using anti-inflammatory agents (P = 0.03). The colchicine subgroup analysis showed that colchicine yielded a promising reduction in the primary end points (OR 0.81, CI 0.70-0.95; P = 0.009) compared with placebo. Anti-inflammatory agents were associated with a higher risk of infection (OR 1.13, CI 1.03-1.23; P = 0.007) and negligible effects on cancers (OR 0.98, CI 0.90-1.06; P = 0.61). Conclusion: Anti-inflammatory agents appear to have beneficial effects in reducing the risk of recurrent myocardial infarction in patients with stable CHD, albeit at the cost of increased infection. Notably, colchicine demonstrates a promising cardioprotective effect with a lower incidence of major cardiovascular events and thus is a potential therapeutic strategy for stable CHD patients. Systematic Review Registration: PROSPERO, identifier CRD42021245514.

Project description:Background: Coronary heart disease (CHD) poses a serious threat to public health, and the current medical management still faces significant challenges. Reliable evidence on the efficacy of Shuxuening injection (SXNI) in CHD is still lacking, even though it is widely used in China. Purpose: To evaluate the efficacy of SXNI combination therapy in treating CHD. Methods: A systematic search of eight databases was conducted to identify relevant randomized controlled trials (RCTs) from the inception of each database until June 2023. ROB 2.0, RevMan 5.4, and Stata 15.1 were used for quality evaluation and data analysis. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the quality of evidence. Results: A total of 3,779 participants from 39 studies were included. The results showed SXNI combination therapy increased the clinical efficacy and decreased the frequency and duration of angina. Furthermore, SXNI combination therapy improved cardiac function of patients by decreasing LVEDD, and increased CI, CO, and LVEF. It also improved blood lipid profiles by increasing HDL, decreasing TC, TG, and LDL. The thrombosis factors of patients were also improved by decreasing FIB, PV, HCT, and HS. Moreover, SXNI combination therapy was superior to the conventional treatment in improving CRP levels, increasing ECG efficacy and BNP. However, due to the limited safety information, reliable safety conclusions could not be drawn. Furthermore, the levels of evidence ranged from very low to moderate due to publication bias and heterogeneity. Conclusion: SXNI can effectively improve angina symptoms, clinical efficacy, cardiac function, blood lipid indicators, and thrombosis factors of patients with CHD. However, more multi-center and large-sample studies are needed to confirm the conclusions due to the limitations of this study. Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=399606; Identifier: CRD42023433292.

Dataset Information

Is coronary heart disease rising in India? A systematic review based on ECG defined coronary heart disease.

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Is coronary heart disease rising in India? A systematic review based on ECG defined coronary heart disease.

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