Major Determinants of Early-Onset Coronary Artery Disease: A Descriptive Study From a Tertiary Care Hospital in Dubai, United Arab Emirates (2018-2022)

TL;DR

This study identifies major risk factors for early-onset heart disease in young adults in Dubai, including high cholesterol, male gender, and obesity.

Contribution

The study provides new insights into the specific risk factors for early-onset coronary artery disease in the UAE population.

Findings

Dyslipidemia was present in 83.6% of patients, making it a major risk factor for early-onset CAD.

Male gender was strongly associated with early-onset CAD, with 70% of patients being men.

South Asian ethnicity showed higher diabetes prevalence and greater co-morbidity severity compared to non-Asians.

Abstract

Background: Premature coronary artery disease (CAD) is becoming increasingly prevalent among young adults worldwide, including in the United Arab Emirates (UAE). This rising trend poses a significant public health concern, increasing morbidity and mortality while burdening healthcare systems. As urbanization and lifestyle changes escalate, understanding the key determinants of premature CAD is crucial. Objectives include assessing early-onset CAD patients, documenting their clinical and demographic characteristics, and identifying key contributors to disease occurrence.

Methods: A five-year descriptive study (2018-2022) was conducted using data from the catheterization laboratory of a tertiary care hospital in Dubai. Premature CAD was defined as CAD in men under 45 years and women under 55 years, confirmed by symptomatic presentation and angiographic evidence of ≥50% stenosis in coronary arteries. Cardiovascular risk factors including dyslipidemia (DLP), hypertension (HTN), gender, and body mass index (BMI) were analyzed. Continuous variables were summarized using mean (standard deviation) and categorical variables as frequencies (percentages). Chi-squared and t-tests assessed differences, with significance set at p < 0.05.

Results: Among 110 patients, 77 (70%) were men, with a mean age of 42.0 (3.6) years, significantly younger than women at 48.8 (4.4) years (p < 0.001). Most participants were Asian (70, 64%), while UAE nationals accounted for 19 (17.2%). Obesity was more prevalent among women (20, 60.6%) than men (28, 36.4%) (p = 0.063). Most patients were non-smokers (86, 78.2%), with all smokers being men (24, 31.2%) (p < 0.001). Regarding cardiovascular risk factors, 63 (57.3%) had HTN, 37 (33.6%) had diabetes mellitus (DM), and 92 (83.6%) had DLP. A significant proportion were overweight (47, 42.7%) or obese (48, 43.6%). HTN was significantly lower in men (37, 48.1%) than in women (26, 78.8%) (p = 0.003). DM was also less common in men (19, 24.7%) than in women (18, 54.5%) (p = 0.004). While DLP and family history prevalence were similar between genders, women had greater co-morbidity severity (p = 0.027). HTN was more common in overweight (18, 48.6%) and obese (17, 45.9%) men than those with normal weight (2, 5.4%) (p = 0.038). A similar trend was seen in women, with HTN being higher in overweight (7, 26.9%) and obese (18, 69.2%) individuals than those of normal weight (1, 3.8%) (p = 0.059). No significant demographic differences were observed between UAE nationals and non-nationals, though DM was lower in UAE nationals (2, 10.5%) than non-nationals (35, 38.5%) (p = 0.030). Comparing Asians (70, 63.6%) and non-Asians (40, 36.4%), Asians smoked less (10, 14.3%) than non-Asians (14, 35.0%) (p = 0.016) but had higher DM prevalence (32, 45.7%) vs. non-Asians (5, 12.5%) (p < 0.001). Asians also had greater co-morbidity severity, with 33 (47.1%) having at least three conditions compared to three (7.5%) among non-Asians (p < 0.001).

Conclusion: This study highlights key risk factors associated with premature CAD in young adults, with DLP, male gender, HTN, overweight status, and South Asian ethnicity emerging as notable associated factors. These findings underscore the need for targeted public health interventions, awareness campaigns, and lifestyle modifications to help mitigate the burden of premature CAD and improve long-term cardiovascular outcomes in the UAE.