10 -Years Coronary Artery Disease Incidence and its Predictors in Overweight and Obese Adults Using A Competing Risk Model:  A Longitudinal Study of Yazd Healthy Heart Cohort (YHHC)

We applied competing risk model to identify the predictors for Coronary Artery Disease (CAD) among 866 overweight and obese participants aged 20-74 years using their registered medical records in the first and second phase of Healthy Heart Cohort (YHHC) conducted in Yazd. These participants were free of coronary heart disease in the first phase of study. CAD was considered as the primary event and all other noncardiac deaths were considered as a competing event. The cumulative incidence of any CAD at the 5-year and 10-year follow-ups was approximately 6.8% and 10.6%, respectively, and approximately 4.6% and 8.5%, respectively, for all other noncardiac deaths. In both cause-specific and Fine-Gray models of risk factor diabetes type II, hypertriglyceridemia, university level of education (reversely), uric acid, age, systolic blood pressure and female gender (reversely) were associated with the increase risk of CAD. In addition to other traditional cardio metabolic risk factor we found that uric acid increased the risk of CAD in overweight and obese adults. It seems that lifestyle modification can reduce the risk of CAD. Also, high level of education had a protective effect on the risk of CAD. Both cause-specific and fine-gray models predicted similarly 10-years of CAD. The use of competing risk models in the presence of competing events is emphasized when interpreting survival studies.