Conventional and regionally distinctive risk factors for first-onset myocardial infarction: the Bangladesh Risk of Acute Vascular Events (BRAVE) case-control study.
| Title: | Conventional and regionally distinctive risk factors for first-onset myocardial infarction: the Bangladesh Risk of Acute Vascular Events (BRAVE) case-control study. |
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| Authors: | Chowdhury R; Department of Global Health, Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.; Naheed A; Initiative for Non Communicable Disease, Health Systems Studies Division, icddr,b, Mohakhali, Dhaka, Bangladesh.; Non Communicable Diseases, Nutrition Research Division, icddr,b, Mohakhali, Dhaka, Bangladesh.; Monower MM; Initiative for Non Communicable Disease, Health Systems Studies Division, icddr,b, Mohakhali, Dhaka, Bangladesh.; Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh.; Shahzad S; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Raqib R; Non Communicable Diseases, Nutrition Research Division, icddr,b, Mohakhali, Dhaka, Bangladesh.; Infectious Diseases Division, icddr,b, Mohakhali, Dhaka, Bangladesh.; Tasmin I; Initiative for Non Communicable Disease, Health Systems Studies Division, icddr,b, Mohakhali, Dhaka, Bangladesh.; Spackman S; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.; Kaptoge S; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.; Pennells L; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.; Butterworth AS; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.; British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK.; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK.; Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK.; Danesh J; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.; British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK.; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK.; Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK.; Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK.; Di Angelantonio E; British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.; Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK.; British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK.; National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK.; Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK.; Health Data Science Research Centre, Human Technopole, Milan, Italy. |
| Source: | The Lancet regional health. Southeast Asia [Lancet Reg Health Southeast Asia] 2024 Dec 19; Vol. 32, pp. 100519. Date of Electronic Publication: 2024 Dec 19 (Print Publication: 2025). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Ltd Country of Publication: England NLM ID: 9918419282806676 Publication Model: eCollection Cited Medium: Internet ISSN: 2772-3682 (Electronic) Linking ISSN: 27723682 NLM ISO Abbreviation: Lancet Reg Health Southeast Asia Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [London] : Elsevier Ltd., [2022]- |
| Abstract: | Background: South Asians may be particularly susceptible to premature myocardial infarction (MI) owing both to conventional cardiovascular risk factors and practices distinctive to South Asia. Identifying modifiable risk factors for MI in these populations could inform prevention strategies. We have, therefore, studied conventional risk factors and other characteristics in relation to occurrence of first MI in Bangladesh.; Methods: In a case-control study involving 8133 first-onset MI cases and 8124 controls recruited in Bangladesh, we calculated odds ratios (ORs) for MI adjusted, for age, sex, smoking status, history of diabetes, history of hypertension, family history of MI, and LDL-cholesterol. We assessed the potential public health impact of risk factor modification using population attributable fractions (PAFs).; Findings: The median (IQR) age of first MI was 53 (45-60) years. Adjusted ORs (95% CIs) were 2.80 (2.57-3.05) for cigarette smoking, 2.17 (1.94-2.43) for family history of MI, 2.27 (2.07-2.48) for history of hypertension, 1.91 (1.72-2.13) for history of diabetes, and 1.53 (1.47-1.58) per 1-SD higher LDL-cholesterol. The highest PAFs (95% CIs) were with current cigarette smoking (49% [46%-52%]), higher LDL-cholesterol (31% [29%-33%]) and history of hypertension (15% [13%-16%]). As for regionally distinctive practices, ORs were 4.02 (3.13-5.17) with biri/hukkah smoking, 2.09 (1.52-2.87) with chewing tobacco, and 1.26 (1.05-1.51) with parental history of first-cousin marriage.; Interpretation: Our results confirm the relevance of several conventional risk factors to risk of first MI in Bangladesh, and identify associations with MI of practices distinctive to South Asia, including indigenous modes of tobacco consumption and parental first-cousin marriage. These findings suggest opportunities for cardiovascular disease prevention in Bangladesh that embrace both conventional and regionally distinctive risk factors.; Funding: The BRAVE Study Coordinating Centre is underpinned by grants from the British Heart Foundation, UK Medical Research Council and National Institute for Health Research Cambridge Biomedical Research Centre.; (© 2024 The Authors.) |
| Competing Interests: | John Danesh holds a British Heart Foundation Professorship and an NIHR Emeritus Senior Investigator Award [∗]. John Danesh serves on scientific advisory boards for AstraZeneca, Novartis, and UK Biobank, and has received multiple grants from academic, charitable and industry sources outside of the submitted work. Emanuele Di Angelantonio holds an NIHR Senior Investigator Award [∗]. Adam Butterworth reports institutional grants from AstraZeneca, Bayer, Biogen, BioMarin, Bioverativ, Novartis, Regeneron and Sanofi. ∗The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. |
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| Contributed Indexing: | Keywords: Myocardial infarction; Risk factors; South Asia |
| Entry Date(s): | Date Created: 20250115 Latest Revision: 20250129 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11730263 |
| DOI: | 10.1016/j.lansea.2024.100519 |
| PMID: | 39811539 |
| Database: | MEDLINE |
Journal Article