AIM: To assess the association between conventional risk factors and acute coronary syndrome in Albania, a transitional country in Southeast Europe. METHODS: A population-based case-control study was conducted in Tirana in 2003-2006. A total of 467 consecutive patients with nonfatal acute coronary syndrome were recruited. There were 370 men with mean+/-standard deviation (SD) age of 59.1+/-8.7 years and 97 women with mean+/-SD age of 63.3+/-7.1 years. The control group comprised a population-representative sample of Tirana residents. In the control group, there were 469 men with mean+/-SD age of 53.1+/-10.4 years and 268 women aged 54.0+/-10.9 years. A structured questionnaire on demographic, socioeconomic, psychosocial factors, and health behaviors was administered. Physical measurements included anthropometrics and blood pressure. Venous blood and adipose tissue aspirations from the gluteal region were frozen-stored for future analysis. Multivariable-adjusted logistic regression was used to assess the independent associations of conventional risk factors with acute coronary syndrome. RESULTS: Upon adjustment for covariates, family history of coronary heart disease was found to be a strong predictor of acute coronary syndrome in both men (odds ratio [OR], 3.70; 95% confidence interval [CI], 2.58-5.30) and women (OR, 4.53; 2.40-8.57). Waist-to-hip ratio in men (OR, 4.03; 2.83-5.73) and obesity in women (OR, 3.31; 1.54-7.14) were strongly associated with acute coronary syndrome. In men, but not in women, there was a significant association with hypertension and current smoking (P=0.011 and P<0.001, respectively). Diabetes was not significantly independently associated in either sex. CONCLUSION: Classical risk factors predicted coronary heart disease in Albania, similarly as in the rest of the world, although associations with family history and anthropometric indices were stronger. These findings are resulting largely from the heterogeneous adoption of lifestyles conducive to increased coronary risk in transitional countries, and they point to the urgent need for targeted public health interventions.
AIM: To assess the association between conventional risk factors and acute coronary syndrome in Albania, a transitional country in Southeast Europe. METHODS: A population-based case-control study was conducted in Tirana in 2003-2006. A total of 467 consecutive patients with nonfatal acute coronary syndrome were recruited. There were 370 men with mean+/-standard deviation (SD) age of 59.1+/-8.7 years and 97 women with mean+/-SD age of 63.3+/-7.1 years. The control group comprised a population-representative sample of Tirana residents. In the control group, there were 469 men with mean+/-SD age of 53.1+/-10.4 years and 268 women aged 54.0+/-10.9 years. A structured questionnaire on demographic, socioeconomic, psychosocial factors, and health behaviors was administered. Physical measurements included anthropometrics and blood pressure. Venous blood and adipose tissue aspirations from the gluteal region were frozen-stored for future analysis. Multivariable-adjusted logistic regression was used to assess the independent associations of conventional risk factors with acute coronary syndrome. RESULTS: Upon adjustment for covariates, family history of coronary heart disease was found to be a strong predictor of acute coronary syndrome in both men (odds ratio [OR], 3.70; 95% confidence interval [CI], 2.58-5.30) and women (OR, 4.53; 2.40-8.57). Waist-to-hip ratio in men (OR, 4.03; 2.83-5.73) and obesity in women (OR, 3.31; 1.54-7.14) were strongly associated with acute coronary syndrome. In men, but not in women, there was a significant association with hypertension and current smoking (P=0.011 and P<0.001, respectively). Diabetes was not significantly independently associated in either sex. CONCLUSION: Classical risk factors predicted coronary heart disease in Albania, similarly as in the rest of the world, although associations with family history and anthropometric indices were stronger. These findings are resulting largely from the heterogeneous adoption of lifestyles conducive to increased coronary risk in transitional countries, and they point to the urgent need for targeted public health interventions.
Authors: Martha L Daviglus; Jeremiah Stamler; Amber Pirzada; Lijing L Yan; Daniel B Garside; Kiang Liu; Renwei Wang; Alan R Dyer; Donald M Lloyd-Jones; Philip Greenland Journal: JAMA Date: 2004-10-06 Impact factor: 56.272