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Background: Traditional risk factors (RFs), such as obesity, family history of premature coronary heart disease (CHD), hypertension, diabetes mellitus, and cigarette smoking have been shown to be significantly associated with early-onset CHD. Familial hypercholesterolemia (FH) is also a major genetic risk factor of premature CHD. Methods: This study was conducted on 100 patients with premature CHD (age<55 years in males and<60 years in females) who were admitted to hospital with acute coronary syndrome or stable coronary artery disease referred for coronary angiography, with a focus on RFs. Results: Male patients constituted 74% of the patients. In all patients, smoking (64%), obesity (64%), abdominal obesity (71%), increased LDL cholesterol (67%), hypertension (54%), positive family history of CHD (43%), and diabetes mellitus (34%) were the most prevalent risk factors. There were 26 patients diagnosed as having definite/probable FH (26%) using DLCNC score. The most common diagnosis was St-elevation myocardial infarction (STEMI) (53%) which was more prevalent in males compared to females [(60.8%) vs (30.8%), (p<0.001)]. Female patients had higher prevalence of hypertension [(73.1%) vs (47.3%), (p=0.023)], diabetes mellitus [(53.8%) vs (27%), (p=0.013)], Obesity [(80.8%) vs (58.1%), (P=0.038)] and definite/probable FH [(46.1%) vs (18.9%), (p=0.024)] as compared to male patients. On the other hand, male patients had higher prevalence of smoking [(85.1%) vs (3.8%), (p<0.001)] and reduced HDL cholesterol levels [(73%) vs (42.3%), (p=0.005)] compared to female patients. Conclusions: Traditional risk factors and FH were significantly related to premature CHD. Significant sex differences were also observed for multiple RFs.

cardiology and cardiovascular research

The Pattern of Risk Factor Profile and Dutch Lipid Clinic Network Criteria of Familial Hypercholesterolemia in Egyptian Patients with Premature Coronary Heart Disease