Risk Factors of Coronary Artery Disease in Palestinian Patients Undergoing Coronary Angiography: A Case–Control Study

Abstract

Aims: To identify the most significant risk factors of coronary artery disease (CAD) in Palestinian patients undergoing coronary angiography. Study Design: A retrospective case control design. Place and Duration of Study: The study was conducted in the only two cardiac catheterization centers in Gaza strip, Palestinian territories (European center in the south and Julis center in the mid-zone) from June to September 2010. Methodology: Based on coronary angiography results, we recruited a systematic random sample of 100 cases formally diagnosed with CAD matched with sex to 100 controls who had normal findings and were free from the disease. Data was collected using a questionnaire which included socio-demographic data and health profile. Chi square, univariate and multivariate logistic regression were used to test the differences between cases and controls and to determine the predictors of CAD. Results: Most cases were male (72.9%), ≥50 years old (70%) and living in refugee camps (57.9%). The most common risk factors were physical inactivity (OR 3.96, P=0.002), hypertension (OR 2.73, P<0.001), diabetes (OR 2.21, P=0.006), LDL/HDL ratio ≥3 (OR 3.76, P<0.001), smoking (OR 1.96, P=0.031), positive family history (OR 2.12, P=0.012), multigravida (OR 10.5, P=0.034) and living in refugee camps (OR 1.92, P=0.023). Coronary artery disease was not significantly correlated with age, body mass index, unemployment and monthly income. Conclusion: Sedentary lifestyle, high LDL, low HDL, hypertension, diabetes, positive family history, smoking and multigravida remain the major modifiable risk factors of CAD among the Palestinians. Living in the refugee camps imposes more risk to have CAD. Gender differences indicated that the prevalence of CAD in males is more than females. Community-based interventions to promote exercise, family planning and smoking cessation in addition to improving the refugee life conditions may be crucial in decreasing the burden of coronary artery disease in Gaza strip.