Risk factors associated with Acute Myocardial Infarction (MI) in patients reporting at tertiary care hospitals in Karachi

Risk factors associated with Acute Myocardial Infarction (MI) in patients reporting at tertiary care hospitals in Karachi | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Risk factors associated with Acute Myocardial Infarction (MI) in patients reporting at tertiary care hospitals in Karachi Syed Rohan Ali, Gulzar Ali Buriro, Fatima Amin Moti, Tanzeel Guzdar, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4372701/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Cardiovascular diseases have a multi-factorial etiology, that includes hypertension, diabetes, stress, smoking, dyslipidemia and positive family history. Of them Acute myocardial infarction remains one of the most life threatening condition that can lead to post MI complications or death. Objective: To determine the risk factors associated with Acute Myocardial infarction in patients presenting in tertiary care hospitals in Karachi. Method: A cross sectional study was conducted on a sample size of 377 Acute Myocardial Infarcted patients .The sample was taken through non probability purposive sampling from Dr. Ruth K. M. Pfau Civil Hospital Karachi and National institute of Cardiovascular Diseases (NICVD) Karachi.. Data was then analyzed using SPSS version 22 with 95% confidence interval, margin of error was taken 5% and P-value 0.05 was significant. Results: A study was conducted to characterize patient demographics and assess the prevalence of various health factors among individuals presenting with Acute Myocardial Infarction (MI) at a tertiary care hospital in Karachi. Among the 377 patients analyzed, 40.3% fell within the age range of 56-65 years, totaling 152 individuals. The male representation was higher, constituting 57.8% (218 out of 377), compared to females at 42.2%. A considerable proportion, totaling 77.7%, had hypertension, while approximately 52.5% were smokers. Diabetes was present in only 36.3% of participants, whereas 38.2% reported dyslipidemia. Additionally, 67.4% had a positive family history of MI, and a mere 9.5% engaged in regular exercise. Consumption of whisky was reported by 19.6% of participants, and 60.5% had undergone surgical procedures. Significantly, male participants exhibited a higher prevalence of smoking (83%) compared to females at 10.69% (p-value = 0.000). Alcohol consumption was also notably higher in males, reported at 30.7%, in contrast to females at 4.40% (p-value = 0.000). Surgical procedures were more prevalent among female participants, with 77.35% having undergone them, compared to 48.16% of males (p-value = 0.000).Furthermore, there was a significant association between age groups and the presence of hypertension, diabetes, and dyslipidemia (p-values = 0.000, 0.001, and 0.000, respectively), suggesting variations in prevalence across different age brackets. Conclusion: The study highlights the prevalence of various health factors among the sampled population, with significant gender disparities observed in smoking, alcohol consumption, and surgical procedures. Understanding these factors is crucial for implementing targeted interventions and public health initiatives to address prevalent health issues within the community. Further research may delve into the underlying factors contributing to these disparities and explore effective strategies for health promotion and disease prevention. Acute MI HTN DM Dyslipidemia Smoking Karachi Introduction It is well known that cardiovascular disease (CVD) has a multifactorial etiology, and a number of variables, including elevated BMI, hypertension (HTN), stress, and diabetes, influence CVD risk. 14 The best strategy for battling the CVD epidemic in resource-constrained countries is CVD prevention. 21 The most common risk factors include smoking, dyslipidemia, sedentary lifestyles, obesity, hypertension, diabetes, and a positive family history or prior MI experience. One potentially fatal disorder that can cause complications or even death is acute myocardial infarction The European Society of Cardiology and the American College of Cardiology established criteria for the diagnosis of Acute Myocardial Infarction, which included the presence of two out of the three following factors::. 1. Regular chest pain that lasts at least 20 minutes 2. An electrocardiogram with ST elevation in two or more consecutive leads that is at least 2 mm elevated and subsequent ECG evolution. 3. A diagnostic marker for the heart, like a two-fold increase in creatinine kinase with at least 10% MB fraction or a positive or increased troponin I (T) level. 14 A study that examined parental history of modifiable risk factors and the relationship with long-term cardiovascular risk in the offspring used a special inter-generational longitudinal community-based cohort. They discovered a link between parental obesity and smoking and eventual CVD in the offspring. Intriguingly, independent of the offspring's obesity state, a family history of obesity was linked to a higher risk of developing cardiovascular disease in the future. On the other hand, the offspring's smoking status appeared to be a mediating factor in the connection between parental smoking status and offspring CVD. Although having a parent with cardiovascular disease increased the likelihood of developing the disease as well as some cardiac events like MI, HF, and AF, parental risk variables had no effect on this association. Further, findings from the Physician's Health Study cohort suggest that leading a healthy lifestyle was related with a decreased risk of heart failure (HF) with antecedent MI in children with a positive family history of premature MI; this association appeared to be stronger in the younger demographic. 2 Early-onset or premature MI is catastrophic because it stunts economic growth by forcing young persons to retire early, take excessive amounts of time off work due to illness, or both Hospitalization, treatment, and rehabilitation expenses connected to MI drive up healthcare spending and put a pressure on national economies. 16 By evaluating the major and modifiable risk factors of acute MI in patients presenting to tertiary care hospital, we will expand our knowledge regarding the preventive strategies that include lifestyle and dietary changes. Our study's objective is to identify the risk factors for MI in Karachi residents and to evaluate the condition in detail. Material and method A cross-sectional study will be conducted on a sample size of 377 MI patients calculated by RAOSOFT software with an estimated population size of 200000. The sample will be taken through nonprobability purposive sampling from Dr. Ruth K. M. Pfau Civil Hospital Karachi and National Institute of Cardiovascular Diseases (NICVD) Karachi, within a period of 6 months from November 2023 to January 2024. Informed verbal consent will be taken from the patient. A study will be conducted to assess the validity of the questionnaire. A structured questionnaire will be distributed for data collection by the researcher. Data will be analyzed using SPSS Version 22 with a 95% confidence interval, the margin of error will be taken as 5% and a P-value of 0.05 was considered significant. Effect modifiers, Chi-square values of age, gender, educational status, and history of diabetes and hypertension will be controlled with stratification. Results A study was conducted to characterize patient demographics and assess the prevalence of various health factors among individuals presenting with Acute Myocardial Infarction (MI) at a tertiary care hospital in Karachi. Among the 377 patients analyzed, 40.3% fell within the age range of 56–65 years, totaling 152 individuals. The male representation was higher, constituting 57.8% (218 out of 377), compared to females at 42.2%. A considerable proportion, totaling 77.7%, had hypertension, while approximately 52.5% were smokers. Diabetes was present in only 36.3% of participants, whereas 38.2% reported dyslipidemia. Additionally, 67.4% had a positive family history of MI, and a mere 9.5% engaged in regular exercise. Consumption of whisky was reported by 19.6% of participants, and 60.5% had undergone surgical procedures. Significantly, male participants exhibited a higher prevalence of smoking (83%) compared to females at 10.69% (p-value = 0.000). Alcohol consumption was also notably higher in males, reported at 30.7%, in contrast to females at 4.40% (p-value = 0.000). Surgical procedures were more prevalent among female participants, with 77.35% having undergone them, compared to 48.16% of males (p-value = 0.000). Furthermore, there was a significant association between age groups and the presence of hypertension, diabetes, and dyslipidemia (p-values = 0.000, 0.001, and 0.000, respectively), suggesting variations in prevalence across different age brackets. Discussion The prevalence of cardiovascular diseases (CVDs), including acute myocardial infarction (MI), poses a significant public health concern worldwide. A comprehensive understanding of the risk factors associated with acute MI is essential for devising effective preventive strategies and mitigating the burden of this life-threatening condition. In a recent study conducted at a tertiary care hospital in Karachi, several key findings shed light on the prevailing risk factors and their implications for preventive interventions. Among individuals aged 56–65 years, the prevalence of heart disease was notably high at 40.3%. This underscores the substantial burden of CVDs within this age group, highlighting the need for targeted screening and management efforts to identify and address cardiovascular risk factors effectively. Furthermore, the study revealed a gender disparity in the distribution of risk factors, with a higher prevalence of heart disease among males (57.8%) compared to females (42.2%). Such differences emphasize the importance of considering gender-specific factors in cardiovascular risk assessment and intervention strategies. Hypertension emerged as the most significant risk factor, affecting 77.7% of the study participants. This finding aligns with previous research highlighting hypertension as a leading risk factor for CVDs, including MI. 14 Effective management and control of hypertension are crucial in reducing the risk of adverse cardiovascular events and improving patient outcomes. Moreover, the high prevalence of hypertension underscores the importance of population-wide initiatives aimed at promoting healthy lifestyle choices and enhancing awareness about the importance of blood pressure monitoring and management. Smoking was identified as another prominent risk factor for acute MI, with 52.5% of participants reporting a history of smoking. Notably, there was a stark gender difference in smoking prevalence, with a significantly higher proportion of males (83%) reporting smoking habits compared to females (10.69%). This observation underscores the need for targeted smoking cessation interventions, particularly among male populations, to reduce the incidence of smoking-related cardiovascular complications. 16 Diabetes mellitus was found to be less prevalent but remains a significant risk factor for acute MI, affecting 36.3% of the study population. The association between diabetes and increased mortality rates in diabetic patients underscores the importance of effective diabetes management in preventing adverse cardiovascular outcomes. Comprehensive diabetes care, including glycemic control, lifestyle modifications, and cardiovascular risk factor management, is essential in reducing the burden of diabetes-related cardiovascular complications. Dyslipidemia, characterized by abnormal lipid levels, was present in 38.2% of participants, indicating its role as a modifiable risk factor for acute MI. The prevalence of dyslipidemia was higher than observed in a similar study conducted in Karachi, highlighting the need for targeted lipid-lowering interventions and lifestyle modifications to reduce cardiovascular risk. 2 A notable proportion of participants reported a positive family history of CVD, consistent with the intergenerational transmission of cardiovascular risk observed in previous studies. Family history serves as a crucial marker for identifying individuals at higher risk of developing CVDs, emphasizing the importance of targeted screening and preventive interventions in high-risk populations. Physical inactivity was prevalent among the study participants, with only 9.5% engaging in regular exercise. Low levels of physical activity are associated with an increased risk of CVDs, underscoring the importance of promoting active lifestyles through community-based interventions and public health initiatives. 13 In conclusion, the study findings provide valuable insights into the prevalence of various risk factors associated with acute MI in a Karachi population. The high prevalence of hypertension, smoking, diabetes, dyslipidemia, and physical inactivity underscores the urgent need for comprehensive preventive strategies aimed at addressing modifiable risk factors and reducing the burden of CVDs. Effective management of cardiovascular risk factors, promotion of healthy lifestyle behaviors, and targeted interventions tailored to individual patient needs are essential components of a holistic approach to CVD prevention and control. Limitations : Limitations of the study, including its cross-sectional design and reliance on data from two hospitals, are acknowledged, emphasizing the importance of future research using longitudinal studies and multi-center collaborations to validate findings and inform evidence-based interventions. Overall, the study contributes valuable insights into the epidemiology of acute MI in Karachi and provides a foundation for developing effective strategies to improve cardiovascular health outcomes in the region. Conclusion The study highlights the prevalence of various health factors and significant gender disparities observed in smoking, alcohol consumption, surgical procedures. Understanding these factors is crucial for implementing targeted interventions and public health initiatives to address prevalent health issues within the community. Declarations Funding : The authors received no extramural funding for the study. Author Contribution : Concept & Design of Study : Syed Rohan Ali Drafting: Fatima Amin Moti Data Analysis: Syed Rohan Ali Revisiting Critically: Tanzeel Guzdar Final Approval of version: Gulzar Ali Buriro Syed Rohan Ali, Fatima Amin Moti ,Fawad Farooq , Sawera Khan , Faraz Sikander ,Ghulam Muhammad , played a crucial role in refining the content, conducting a final round of editing, and presenting the article in a structured and balanced format , ensuring it was ready for publication. IRB Reference no : IRB-83/2023 NICVD, Karachi Ethics approval granted by IRB Committee NICVD , KHI Verbal consent was obtained from the participates. Data was collected by the investigator. If required data and materials access can be granted. Conflict of Interest: The study has no conflict ofinterest to declare by any author. References Rokkedrejer SI, Schlünssen V, Kinnerup MB, Vestergaard JM, Kolstad HA, Cramer C. Risk of myocardial infarction among pigeon breeders: A follow-up study. Arch Environ Occup Health. 2023;78(9–10):507–11. 10.1080/19338244.2024.2302113 . Taylor CN, Wang D, Larson MG, Lau ES, Benjamin EJ, D'Agostino RB, Sr, Vasan RS, Levy D, Cheng S, Ho JE. Family History of Modifiable Risk Factors and Association With Future Cardiovascular Disease. J Am Heart Assoc. 2023;12(6):e027881. Epub 2023 Mar 9. PMID: 36892090; PMCID: PMC10111537. Desai R, Mishra V, Chhina AK, et al. Cardiovascular Disease Risk Factors and Outcomes of Acute Myocardial Infarction in Young Adults: Evidence From 2 Nationwide Cohorts in the United States a Decade Apart. Curr Probl Cardiol. 2023;48(9):101747. 10.1016/j.cpcardiol.2023.101747 . Nurkina D, Baimuratova M, Zhussupbekova L, Kodaspayev A, Alimbayeva S, ASSESSMENT OF RISK FACTORS OF MYOCARDIAL INFARCTION IN YOUNG PERSONS. Georgian Med News. 2023;(334):71–7. Jeon HS, Byun SJ, Hyon JY, Park KH, Park SJ. Risk of Stroke or Acute Myocardial Infarction in Subconjunctival Hemorrhage: A Nationwide Cohort Study. Ophthalmic Epidemiol. 2022;29(6):662–71. 10.1080/09286586.2021.2003820 . Sagris M, Antonopoulos AS, Theofilis P, et al. Risk factors profile of young and older patients with myocardial infarction. Cardiovasc Res. 2022;118(10):2281–92. 10.1093/cvr/cvab264 . Lu Y, Li S, Liu Y, et al. Sex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults. JAMA Netw Open. 2022;5(5):e229953. 10.1001/jamanetworkopen.2022.9953 . Wereski R, Kimenai DM, Bularga A, et al. Risk factors for type 1 and type 2 myocardial infarction. Eur Heart J. 2022;43(2):127–35. 10.1093/eurheartj/ehab581 . Hasebe T, Hasebe N. Impact of risk factors related to metabolic syndrome on acute myocardial infarction in younger patients. Hypertens Res. 2022;45(9):1447–58. 10.1038/s41440-022-00951-y . Liu W, Tang Q, Jin J, Zhu T, Dai Y, Shi Y. Sex differences in cardiovascular risk factors for myocardial infarction. Geschlechtsunterschiede in Bezug auf kardiovaskuläre Risikofaktoren für einen Myokardinfarkt. Herz. 2021;46(Suppl 1):115–22. 10.1007/s00059-020-04911-5 . Dugani SB, Hydoub YM, Ayala AP, et al. Risk Factors for Premature Myocardial Infarction: A Systematic Review and Meta-analysis of 77 Studies. Mayo Clin Proc Innov Qual Outcomes. 2021;5(4):783–94. 10.1016/j.mayocpiqo.2021.03.009 . Published 2021 Jun 23. Jortveit J, Pripp AH, Langørgen J, Halvorsen S. Incidence, risk factors and outcome of young patients with myocardial infarction. Heart. 2020;106(18):1420–6. 10.1136/heartjnl-2019-316067 . Roth GA, Mensah GA, Johnson CO et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study [published correction appears in J Am Coll Cardiol. 2021;77(15):1958–1959]. J Am Coll Cardiol. 2020;76(25):2982–3021. 10.1016/j.jacc.2020.11.010 . Shafi M, Mehmood H, Afsar S, Bokhari ZR, Abbasi S. Cardiovascular Disease and Its Risk Factors Among Employees of Sindh Government; A Cross Sectional Survey from Karachi, Pakistan. Int J Frontier Sci. 2019;3(2):84–90. Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2019;394:1145–58. Abed MA, Eshah NF, Moser DK. Risk profile of myocardial infarction in young versus older adults. Heart Lung. 2018 May-Jun;47(3):226–230. 10.1016/j.hrtlng.2018.03.002 . Epub 2018 Apr 4. PMID: 29627074. Bahall M, Seemungal T, Legall G. Risk factors for first-time acute myocardial infarction patients in Trinidad. BMC Public Health. 2018;18:161. https://doi.org/10.1186/s12889-018-5080-y . Gibson P, Narous M, Firoz T, Chou D, Barreix M, Say L, James M, WHO Maternal Morbidity Working Group. Incidence of myocardial infarction in pregnancy: a systematic review and meta-analysis of population‐based studies. Eur Heart J Qual Care Clin Outcomes. 2017;3:198–207. Lisowska A, Makarewicz-Wujec M, Filipiak KJ. Risk factors, prognosis, and secondary prevention of myocardial infarction in young adults in Poland. Kardiol Pol. 2016;74(10):1148–53. 10.5603/KP.a2016.0098 . Pedersen LR, Frestad D, Michelsen MM, et al. Risk Factors for Myocardial Infarction in Women and Men: A Review of the Current Literature. Curr Pharm Des. 2016;22(25):3835–52. 10.2174/1381612822666160309115318 . Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham heart study and the epidemiology of cardiovascular diseases: a historical perspective. Lancet. 2014;383(9921):999–1008. Ryoo JH, Cho SH, Kim SW. Prediction of risk factors for coronary heart disease using Framingham risk score in Korean men. PLoS ONE. 2012;7(9):e45030. Gersh BJ, Sliwa K, Mayosi BM, Yusuf S. Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications. Eur Heart J. 2010;31:642–8. Kreatsoulas C, Anand SS. The impact of social determinants on cardiovascular disease. Can J Cardiol. 2010;26(Suppl C):C8–13. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): a case-control study. Lancet. 2004;364(9438):937–52. Khan MS, Jafary FH, Jafar TH, et al. Knowledge of modifiable risk factors of heart disease among patients with acute myocardial infarction in Karachi, Pakistan: a cross sectional study. BMC Cardiovasc Disord. 2006;6:18. Tables Table no 01 Demographic Information : Category Frequency Percent Age 35 to 45 82 21.8 46 to 55 91 24.1 56 to 65 152 40.3 66 to 75 52 13.8 Gender Male 218 57.8 Female 159 42.2 Table no 2 Cross tab summary with P value. Question Categories Count Total P-Value Do you have Hypertension? yes, no 293, 84 377 0.000 Since when you are Hypertensive? < 5yrs, 5 to 10 yrs, 10 to 20 yrs, 20 + yrs, nil 98, 87, 85, 26, 81 377 0.000 Are you diabetic? yes, no 137, 240 377 0.001 Since when were you diabetic? 15yrs, nil 53, 45, 27, 21, 231 377 0.005 Do you have Dyslipidemia? yes, no 144, 233 377 0.000 Does anyone from your family has an MI? yes, no 254, 123 377 0.001 Do you exercise daily? yes, no 36, 341 377 0.017 Do you take any other drugs? naswar, gutka, betel nuts, pan, none, others 52, 52, 107, 35, 93, 38 377 0.000 Are you a smoker? yes, no 198, 179 377 0.000 How many cigarettes do you smoke daily? 1 to 5, 6 to 10, 10 to 20, 20+, nil 59, 57, 46, 4, 211 377 0.000 Do you drink whisky/vine occasionally? yes, no 74, 303 377 0.000 Have you ever gone through any operation(s)? yes, no 228, 149 377 0.000 Do you take any other drugs? naswar, gutka, betel nuts, pan, none, others 52, 52, 107, 35, 93, 38 377 0.000 Table no 03 : Medical Information. Category Frequency Percent Hypertension Yes 293 77.7 No 84 22.3 Smoker Yes 198 52.5 No 179 47.5 Diabetic Yes 137 36.3 No 240 63.7 Dyslipidemia Yes 144 38.2 No 233 61.8 Family history of MI Yes 254 67.4 No 123 32.6 Whisky/vine occasional drink Yes 74 19.6 No 303 80.4 Previous operation(s) Yes 228 60.5 No 149 39.5 Other drug use Naswar 52 13.8 Gutka 52 13.8 Betel nuts 107 28.4 Pan 35 9.3 None 93 24.7 Others 38 10.1 Charts Charts 1 and 2 are available in the Supplementary Files section Additional Declarations No competing interests reported. Supplementary Files floatimage1.png Bar Chart 01. floatimage2.jpeg Bar Chart 2. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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etiology, and a number of variables, including elevated BMI, hypertension (HTN), stress, and diabetes, influence CVD risk.\u003csup\u003e14\u003c/sup\u003e The best strategy for battling the CVD epidemic in resource-constrained countries is CVD prevention.\u003csup\u003e21\u003c/sup\u003e The most common risk factors include smoking, dyslipidemia, sedentary lifestyles, obesity, hypertension, diabetes, and a positive family history or prior MI experience. One potentially fatal disorder that can cause complications or even death is acute myocardial infarction The European Society of Cardiology and the American College of Cardiology established criteria for the diagnosis of Acute Myocardial Infarction, which included the presence of two out of the three following factors::.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1. Regular chest pain that lasts at least 20 minutes\u003c/p\u003e\n\u003cp\u003e2. An electrocardiogram with ST elevation in two or more consecutive leads that is at least 2 mm elevated and subsequent ECG evolution.\u003c/p\u003e\n\u003cp\u003e3. A diagnostic marker for the heart, like a two-fold increase in creatinine kinase with at least 10% MB fraction or a positive or increased troponin I (T) level. \u003csup\u003e14\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eA study that examined parental history of modifiable risk factors and the relationship with long-term cardiovascular risk in the offspring used a special inter-generational longitudinal community-based cohort. They discovered a link between parental obesity and smoking and eventual CVD in the offspring. Intriguingly, independent of the offspring\u0026apos;s obesity state, a family history of obesity was linked to a higher risk of developing cardiovascular disease in the future. On the other hand, the offspring\u0026apos;s smoking status appeared to be a mediating factor in the connection between parental smoking status and offspring CVD. Although having a parent with cardiovascular disease increased the likelihood of developing the disease as well as some cardiac events like MI, HF, and AF, parental risk variables had no effect on this association.\u003c/p\u003e\n\u003cp\u003eFurther, findings from the Physician\u0026apos;s Health Study cohort suggest that leading a healthy lifestyle was related with a decreased risk of heart failure (HF) with antecedent MI in children with a positive family history of premature MI; this association appeared to be stronger in the younger demographic.\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eEarly-onset or premature MI is catastrophic because it stunts economic growth by forcing young persons to retire early, take excessive amounts of time off work due to illness, or both Hospitalization, treatment, and rehabilitation expenses connected to MI drive up healthcare spending and put a pressure on national economies.\u003csup\u003e16\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eBy evaluating the major and modifiable risk factors of acute MI in patients presenting to tertiary care hospital, we will expand our knowledge regarding the preventive strategies that include lifestyle and dietary changes. Our study\u0026apos;s objective is to identify the risk factors for MI in Karachi residents and to evaluate the condition in detail.\u003c/p\u003e"},{"header":"Material and method","content":"\u003cp\u003eA cross-sectional study will be conducted on a sample size of 377 MI patients calculated by RAOSOFT software with an estimated population size of 200000. The sample will be taken through nonprobability purposive sampling from Dr. Ruth K. M. Pfau Civil Hospital Karachi and National Institute of Cardiovascular Diseases (NICVD) Karachi, within a period of 6 months from November 2023 to January 2024. Informed verbal consent will be taken from the patient. A study will be conducted to assess the validity of the questionnaire. A structured questionnaire will be distributed for data collection by the researcher. Data will be analyzed using SPSS Version 22 with a 95% confidence interval, the margin of error will be taken as 5% and a P-value of 0.05 was considered significant. Effect modifiers, Chi-square values of age, gender, educational status, and history of diabetes and hypertension will be controlled with stratification.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA study was conducted to characterize patient demographics and assess the prevalence of various health factors among individuals presenting with Acute Myocardial Infarction (MI) at a tertiary care hospital in Karachi. Among the 377 patients analyzed, 40.3% fell within the age range of 56\u0026ndash;65 years, totaling 152 individuals. The male representation was higher, constituting 57.8% (218 out of 377), compared to females at 42.2%. A considerable proportion, totaling 77.7%, had hypertension, while approximately 52.5% were smokers. Diabetes was present in only 36.3% of participants, whereas 38.2% reported dyslipidemia. Additionally, 67.4% had a positive family history of MI, and a mere 9.5% engaged in regular exercise. Consumption of whisky was reported by 19.6% of participants, and 60.5% had undergone surgical procedures.\u003c/p\u003e\n\u003cp\u003eSignificantly, male participants exhibited a higher prevalence of smoking (83%) compared to females at 10.69% (p-value\u0026thinsp;=\u0026thinsp;0.000). Alcohol consumption was also notably higher in males, reported at 30.7%, in contrast to females at 4.40% (p-value\u0026thinsp;=\u0026thinsp;0.000). Surgical procedures were more prevalent among female participants, with 77.35% having undergone them, compared to 48.16% of males (p-value\u0026thinsp;=\u0026thinsp;0.000). Furthermore, there was a significant association between age groups and the presence of hypertension, diabetes, and dyslipidemia (p-values\u0026thinsp;=\u0026thinsp;0.000, 0.001, and 0.000, respectively), suggesting variations in prevalence across different age brackets.\u003c/p\u003e\n"},{"header":"Discussion","content":"\u003cp\u003eThe prevalence of cardiovascular diseases (CVDs), including acute myocardial infarction (MI), poses a significant public health concern worldwide. A comprehensive understanding of the risk factors associated with acute MI is essential for devising effective preventive strategies and mitigating the burden of this life-threatening condition. In a recent study conducted at a tertiary care hospital in Karachi, several key findings shed light on the prevailing risk factors and their implications for preventive interventions.\u003c/p\u003e \u003cp\u003eAmong individuals aged 56\u0026ndash;65 years, the prevalence of heart disease was notably high at 40.3%. This underscores the substantial burden of CVDs within this age group, highlighting the need for targeted screening and management efforts to identify and address cardiovascular risk factors effectively. Furthermore, the study revealed a gender disparity in the distribution of risk factors, with a higher prevalence of heart disease among males (57.8%) compared to females (42.2%). Such differences emphasize the importance of considering gender-specific factors in cardiovascular risk assessment and intervention strategies. Hypertension emerged as the most significant risk factor, affecting 77.7% of the study participants. This finding aligns with previous research highlighting hypertension as a leading risk factor for CVDs, including MI.\u003csup\u003e14\u003c/sup\u003e Effective management and control of hypertension are crucial in reducing the risk of adverse cardiovascular events and improving patient outcomes. Moreover, the high prevalence of hypertension underscores the importance of population-wide initiatives aimed at promoting healthy lifestyle choices and enhancing awareness about the importance of blood pressure monitoring and management. Smoking was identified as another prominent risk factor for acute MI, with 52.5% of participants reporting a history of smoking. Notably, there was a stark gender difference in smoking prevalence, with a significantly higher proportion of males (83%) reporting smoking habits compared to females (10.69%). This observation underscores the need for targeted smoking cessation interventions, particularly among male populations, to reduce the incidence of smoking-related cardiovascular complications.\u003csup\u003e16\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eDiabetes mellitus was found to be less prevalent but remains a significant risk factor for acute MI, affecting 36.3% of the study population. The association between diabetes and increased mortality rates in diabetic patients underscores the importance of effective diabetes management in preventing adverse cardiovascular outcomes. Comprehensive diabetes care, including glycemic control, lifestyle modifications, and cardiovascular risk factor management, is essential in reducing the burden of diabetes-related cardiovascular complications. Dyslipidemia, characterized by abnormal lipid levels, was present in 38.2% of participants, indicating its role as a modifiable risk factor for acute MI. The prevalence of dyslipidemia was higher than observed in a similar study conducted in Karachi, highlighting the need for targeted lipid-lowering interventions and lifestyle modifications to reduce cardiovascular risk.\u003csup\u003e2\u003c/sup\u003e A notable proportion of participants reported a positive family history of CVD, consistent with the intergenerational transmission of cardiovascular risk observed in previous studies. Family history serves as a crucial marker for identifying individuals at higher risk of developing CVDs, emphasizing the importance of targeted screening and preventive interventions in high-risk populations. Physical inactivity was prevalent among the study participants, with only 9.5% engaging in regular exercise. Low levels of physical activity are associated with an increased risk of CVDs, underscoring the importance of promoting active lifestyles through community-based interventions and public health initiatives.\u003csup\u003e13\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn conclusion, the study findings provide valuable insights into the prevalence of various risk factors associated with acute MI in a Karachi population. The high prevalence of hypertension, smoking, diabetes, dyslipidemia, and physical inactivity underscores the urgent need for comprehensive preventive strategies aimed at addressing modifiable risk factors and reducing the burden of CVDs. Effective management of cardiovascular risk factors, promotion of healthy lifestyle behaviors, and targeted interventions tailored to individual patient needs are essential components of a holistic approach to CVD prevention and control.\u003c/p\u003e\n\u003ch3\u003e \u003c/h3\u003e\n\u003cdiv class=\"Heading\"\u003e\u003cb\u003eLimitations\u003c/b\u003e :\u003c/div\u003e \u003cp\u003eLimitations of the study, including its cross-sectional design and reliance on data from two hospitals, are acknowledged, emphasizing the importance of future research using longitudinal studies and multi-center collaborations to validate findings and inform evidence-based interventions. Overall, the study contributes valuable insights into the epidemiology of acute MI in Karachi and provides a foundation for developing effective strategies to improve cardiovascular health outcomes in the region.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study highlights the prevalence of various health factors and significant gender disparities observed in smoking, alcohol consumption, surgical procedures. Understanding these factors is crucial for implementing targeted interventions and public health initiatives to address prevalent health issues within the community.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding :\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors received no extramural funding for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution :\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConcept \u0026amp; Design of Study : Syed Rohan Ali\u003c/p\u003e\n\u003cp\u003eDrafting: \u003cu\u003eFatima Amin Moti\u003c/u\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData Analysis: \u003cu\u003eSyed Rohan Ali\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eRevisiting Critically: \u003cu\u003eTanzeel Guzdar\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eFinal Approval of version: \u003cu\u003eGulzar Ali Buriro\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eSyed Rohan Ali, Fatima Amin Moti ,Fawad Farooq , Sawera Khan , Faraz Sikander ,Ghulam Muhammad ,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eplayed a crucial role in refining the content, conducting a final round of editing, and presenting the article in a structured and balanced format , ensuring it was ready for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIRB Reference no\u003c/strong\u003e : IRB-83/2023 \u0026nbsp; NICVD, Karachi\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e granted by IRB Committee NICVD , KHI\u003c/p\u003e\n\u003cp\u003eVerbal consent was obtained from the \u0026nbsp;participates.\u003c/p\u003e\n\u003cp\u003eData was collected by the investigator. If required data and materials access can be granted.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study has no conflict ofinterest to declare by any author.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eRokkedrejer SI, Schl\u0026uuml;nssen V, Kinnerup MB, Vestergaard JM, Kolstad HA, Cramer C. Risk of myocardial infarction among pigeon breeders: A follow-up study. Arch Environ Occup Health. 2023;78(9\u0026ndash;10):507\u0026ndash;11. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1080/19338244.2024.2302113\u003c/span\u003e\u003cspan address=\"10.1080/19338244.2024.2302113\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTaylor CN, Wang D, Larson MG, Lau ES, Benjamin EJ, D'Agostino RB, Sr, Vasan RS, Levy D, Cheng S, Ho JE. Family History of Modifiable Risk Factors and Association With Future Cardiovascular Disease. J Am Heart Assoc. 2023;12(6):e027881. Epub 2023 Mar 9. PMID: 36892090; PMCID: PMC10111537.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDesai R, Mishra V, Chhina AK, et al. Cardiovascular Disease Risk Factors and Outcomes of Acute Myocardial Infarction in Young Adults: Evidence From 2 Nationwide Cohorts in the United States a Decade Apart. Curr Probl Cardiol. 2023;48(9):101747. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.cpcardiol.2023.101747\u003c/span\u003e\u003cspan address=\"10.1016/j.cpcardiol.2023.101747\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNurkina D, Baimuratova M, Zhussupbekova L, Kodaspayev A, Alimbayeva S, ASSESSMENT OF RISK FACTORS OF MYOCARDIAL INFARCTION IN YOUNG PERSONS. Georgian Med News. 2023;(334):71\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJeon HS, Byun SJ, Hyon JY, Park KH, Park SJ. Risk of Stroke or Acute Myocardial Infarction in Subconjunctival Hemorrhage: A Nationwide Cohort Study. Ophthalmic Epidemiol. 2022;29(6):662\u0026ndash;71. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1080/09286586.2021.2003820\u003c/span\u003e\u003cspan address=\"10.1080/09286586.2021.2003820\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSagris M, Antonopoulos AS, Theofilis P, et al. Risk factors profile of young and older patients with myocardial infarction. Cardiovasc Res. 2022;118(10):2281\u0026ndash;92. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1093/cvr/cvab264\u003c/span\u003e\u003cspan address=\"10.1093/cvr/cvab264\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLu Y, Li S, Liu Y, et al. Sex-Specific Risk Factors Associated With First Acute Myocardial Infarction in Young Adults. JAMA Netw Open. 2022;5(5):e229953. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jamanetworkopen.2022.9953\u003c/span\u003e\u003cspan address=\"10.1001/jamanetworkopen.2022.9953\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWereski R, Kimenai DM, Bularga A, et al. Risk factors for type 1 and type 2 myocardial infarction. Eur Heart J. 2022;43(2):127\u0026ndash;35. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1093/eurheartj/ehab581\u003c/span\u003e\u003cspan address=\"10.1093/eurheartj/ehab581\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHasebe T, Hasebe N. Impact of risk factors related to metabolic syndrome on acute myocardial infarction in younger patients. Hypertens Res. 2022;45(9):1447\u0026ndash;58. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/s41440-022-00951-y\u003c/span\u003e\u003cspan address=\"10.1038/s41440-022-00951-y\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu W, Tang Q, Jin J, Zhu T, Dai Y, Shi Y. Sex differences in cardiovascular risk factors for myocardial infarction. Geschlechtsunterschiede in Bezug auf kardiovaskul\u0026auml;re Risikofaktoren f\u0026uuml;r einen Myokardinfarkt. Herz. 2021;46(Suppl 1):115\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00059-020-04911-5\u003c/span\u003e\u003cspan address=\"10.1007/s00059-020-04911-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDugani SB, Hydoub YM, Ayala AP, et al. Risk Factors for Premature Myocardial Infarction: A Systematic Review and Meta-analysis of 77 Studies. Mayo Clin Proc Innov Qual Outcomes. 2021;5(4):783\u0026ndash;94. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.mayocpiqo.2021.03.009\u003c/span\u003e\u003cspan address=\"10.1016/j.mayocpiqo.2021.03.009\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Published 2021 Jun 23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJortveit J, Pripp AH, Lang\u0026oslash;rgen J, Halvorsen S. Incidence, risk factors and outcome of young patients with myocardial infarction. Heart. 2020;106(18):1420\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/heartjnl-2019-316067\u003c/span\u003e\u003cspan address=\"10.1136/heartjnl-2019-316067\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRoth GA, Mensah GA, Johnson CO et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u0026ndash;2019: Update From the GBD 2019 Study [published correction appears in J Am Coll Cardiol. 2021;77(15):1958\u0026ndash;1959]. J Am Coll Cardiol. 2020;76(25):2982\u0026ndash;3021. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jacc.2020.11.010\u003c/span\u003e\u003cspan address=\"10.1016/j.jacc.2020.11.010\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShafi M, Mehmood H, Afsar S, Bokhari ZR, Abbasi S. Cardiovascular Disease and Its Risk Factors Among Employees of Sindh Government; A Cross Sectional Survey from Karachi, Pakistan. Int J Frontier Sci. 2019;3(2):84\u0026ndash;90.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990\u0026ndash;2017: a systematic analysis for the global burden of disease study 2017. Lancet. 2019;394:1145\u0026ndash;58.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbed MA, Eshah NF, Moser DK. Risk profile of myocardial infarction in young versus older adults. Heart Lung. 2018 May-Jun;47(3):226\u0026ndash;230. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.hrtlng.2018.03.002\u003c/span\u003e\u003cspan address=\"10.1016/j.hrtlng.2018.03.002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2018 Apr 4. PMID: 29627074.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBahall M, Seemungal T, Legall G. Risk factors for first-time acute myocardial infarction patients in Trinidad. BMC Public Health. 2018;18:161. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12889-018-5080-y\u003c/span\u003e\u003cspan address=\"10.1186/s12889-018-5080-y\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGibson P, Narous M, Firoz T, Chou D, Barreix M, Say L, James M, WHO Maternal Morbidity Working Group. Incidence of myocardial infarction in pregnancy: a systematic review and meta-analysis of population‐based studies. Eur Heart J Qual Care Clin Outcomes. 2017;3:198\u0026ndash;207.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLisowska A, Makarewicz-Wujec M, Filipiak KJ. Risk factors, prognosis, and secondary prevention of myocardial infarction in young adults in Poland. Kardiol Pol. 2016;74(10):1148\u0026ndash;53. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5603/KP.a2016.0098\u003c/span\u003e\u003cspan address=\"10.5603/KP.a2016.0098\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePedersen LR, Frestad D, Michelsen MM, et al. Risk Factors for Myocardial Infarction in Women and Men: A Review of the Current Literature. Curr Pharm Des. 2016;22(25):3835\u0026ndash;52. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2174/1381612822666160309115318\u003c/span\u003e\u003cspan address=\"10.2174/1381612822666160309115318\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham heart study and the epidemiology of cardiovascular diseases: a historical perspective. Lancet. 2014;383(9921):999\u0026ndash;1008.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRyoo JH, Cho SH, Kim SW. Prediction of risk factors for coronary heart disease using Framingham risk score in Korean men. PLoS ONE. 2012;7(9):e45030.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGersh BJ, Sliwa K, Mayosi BM, Yusuf S. Novel therapeutic concepts: the epidemic of cardiovascular disease in the developing world: global implications. Eur Heart J. 2010;31:642\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKreatsoulas C, Anand SS. The impact of social determinants on cardiovascular disease. Can J Cardiol. 2010;26(Suppl C):C8\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): a case-control study. Lancet. 2004;364(9438):937\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhan MS, Jafary FH, Jafar TH, et al. Knowledge of modifiable risk factors of heart disease among patients with acute myocardial infarction in Karachi, Pakistan: a cross sectional study. BMC Cardiovasc Disord. 2006;6:18.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable no 01 Demographic Information\u003c/strong\u003e:\u003c/p\u003e\n\u003ctable id=\"Taba\" border=\"1\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e35 to 45\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e21.8\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e46 to 55\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e91\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e24.1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e56 to 65\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e152\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e40.3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e66 to 75\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e13.8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e218\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e57.8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e159\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e42.2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable no 2 Cross tab summary with P value.\u003c/strong\u003e\u003c/p\u003e\n \u003ctable id=\"Tabb\" border=\"1\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eQuestion\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategories\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCount\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eP-Value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDo you have Hypertension?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes, no\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e293, 84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSince when you are Hypertensive?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;5yrs, 5 to 10 yrs, 10 to 20 yrs, 20\u0026thinsp;+\u0026thinsp;yrs, nil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e98, 87, 85, 26, 81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAre you diabetic?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes, no\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e137, 240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSince when were you diabetic?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026lt;\u0026thinsp;5yrs, 5 to 10 yrs, 11 to 15 yrs, \u0026gt;\u0026thinsp;15yrs, nil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e53, 45, 27, 21, 231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDo you have Dyslipidemia?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes, no\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e144, 233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDoes anyone from your family has an MI?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes, no\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e254, 123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDo you exercise daily?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes, no\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e36, 341\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDo you take any other drugs?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003enaswar, gutka, betel nuts, pan, none, others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52, 52, 107, 35, 93, 38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAre you a smoker?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes, no\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e198, 179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHow many cigarettes do you smoke daily?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 to 5, 6 to 10, 10 to 20, 20+, nil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e59, 57, 46, 4, 211\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDo you drink whisky/vine occasionally?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes, no\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e74, 303\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHave you ever gone through any operation(s)?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eyes, no\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e228, 149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDo you take any other drugs?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003enaswar, gutka, betel nuts, pan, none, others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52, 52, 107, 35, 93, 38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable no 03 : Medical Information.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable id=\"Tabc\" border=\"1\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercent\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eHypertension\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e293\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e77.7\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e84\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e22.3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoker\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e198\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e52.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e179\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e47.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n 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align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e144\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e38.2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e233\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e61.8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history of MI\u003c/strong\u003e\u003c/p\u003e\n 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align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e39.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther drug use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNaswar\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e52\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e\u003cstrong\u003e13.8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eGutka\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n 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section\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Acute MI, HTN, DM, Dyslipidemia, Smoking, Karachi","lastPublishedDoi":"10.21203/rs.3.rs-4372701/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4372701/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCardiovascular diseases have a multi-factorial etiology, that includes hypertension, diabetes, stress, smoking, dyslipidemia and positive family history. Of them Acute myocardial infarction remains one of the most life threatening condition that can lead to post MI complications or death.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo determine the risk factors associated with Acute Myocardial infarction in patients presenting in tertiary care hospitals in Karachi.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA cross sectional study was conducted on a sample size of 377 Acute Myocardial Infarcted patients .The sample was taken through non probability purposive sampling from Dr. Ruth K. M. Pfau Civil Hospital Karachi and National institute of Cardiovascular Diseases (NICVD) Karachi.. Data was then analyzed using SPSS version 22 with 95% confidence interval, margin of error was taken 5% and P-value 0.05 was significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA study was conducted to characterize patient demographics and assess the prevalence of various health factors among individuals presenting with Acute Myocardial Infarction (MI) at a tertiary care hospital in Karachi. Among the 377 patients analyzed, 40.3% fell within the age range of 56-65 years, totaling 152 individuals. The male representation was higher, constituting 57.8% (218 out of 377), compared to females at 42.2%. A considerable proportion, totaling 77.7%, had hypertension, while approximately 52.5% were smokers. Diabetes was present in only 36.3% of participants, whereas 38.2% reported dyslipidemia. Additionally, 67.4% had a positive family history of MI, and a mere 9.5% engaged in regular exercise. Consumption of whisky was reported by 19.6% of participants, and 60.5% had undergone surgical procedures.\u003c/p\u003e\n\u003cp\u003eSignificantly, male participants exhibited a higher prevalence of smoking (83%) compared to females at 10.69% (p-value = 0.000). Alcohol consumption was also notably higher in males, reported at 30.7%, in contrast to females at 4.40% (p-value = 0.000). Surgical procedures were more prevalent among female participants, with 77.35% having undergone them, compared to 48.16% of males (p-value = 0.000).Furthermore, there was a significant association between age groups and the presence of hypertension, diabetes, and dyslipidemia (p-values = 0.000, 0.001, and 0.000, respectively), suggesting variations in prevalence across different age brackets.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study highlights the prevalence of various health factors among the sampled population, with significant gender disparities observed in smoking, alcohol consumption, and surgical procedures. Understanding these factors is crucial for implementing targeted interventions and public health initiatives to address prevalent health issues within the community. Further research may delve into the underlying factors contributing to these disparities and explore effective strategies for health promotion and disease prevention.\u003c/p\u003e","manuscriptTitle":"Risk factors associated with Acute Myocardial Infarction (MI) in patients reporting at tertiary care hospitals in Karachi","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-21 05:00:40","doi":"10.21203/rs.3.rs-4372701/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f6611146-8100-4e16-9b32-5045e1912602","owner":[],"postedDate":"May 21st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-05-21T05:00:40+00:00","versionOfRecord":[],"versionCreatedAt":"2024-05-21 05:00:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4372701","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4372701","identity":"rs-4372701","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}