A community-based study on electrocardiographic abnormalities of adult population from South India - Findings from a cross sectional survey

Background: There are no data on electrocardiographic (ECG) findings from general population of Indian subcontinent. We analyzed ECG abnormalities of in adults as part of a community survey of prevalence of coronary artery disease and risk factors from South India. Methods and results: In this cross-sectional study of men and women between the ages 20 to 79 years, ECGs recorded digitally were analyzed using the Minnesota code. Electrocardiograms were analyzed for abnormalities in 4630 participants (women 59.6%). The overall prevalence of ECG abnormalities (39.9%) was higher in men (47.24% vs. 34.9% p <0.0001). QRS axis deviation, first degree AV block, fascicular blocks, incomplete right bundle branch block, sinus bradycardia and ST elevation in the anterior chest leads were markedly higher in men. Sinus tachycardia and low voltage QRS occurred more often in women. The overall prevalence of atrial fibrillation was 0.32% which was markedly lower than the western data. Brugada and early repolarisation patterns occurred in 1.06% and 1.56% respectively, equal in both age groups, but markedly higher in men. Brugada pattern occurred more often than in the west, but much less than the Far East population. Early repolarisation pattern was similar to rest of Asian population, but significantly less than the Caucasian population Conclusion: In this community-based study, prevalence of major electrocardiographic abnormalities was high. Overall, men had significantly higher ECG abnormalities

Prevalence of peripheral artery disease and risk factors in the elderly: A community based cross-sectional study from northern Kerala, India

Background and objective There are no data on the prevalence of peripheral artery disease (PAD) and risk factors in Indians. This study was aimed at studying the prevalence of PAD and risk factors in elderly population of northern parts of Kerala, South India. Methods In a prospective observational survey we evaluated men and women of age between 60 and 79 years from Kerala. Anthropometric measurements, biochemical investigations and electrocardiogram were done. The diagnosis of PAD was made by ABI < 0.9. Assessment of coronary artery disease CAD was performed using historical, angina questionnaire and electrocardiographic criteria. Results Of the total sample of 1330, we could evaluate 1148 respondents (86.3%). Overall mean (SD) ABI was 0.97 (0.19). Age-adjusted prevalence of PAD was 26.7% (95% CI (24.3, 29.4)) with no difference between urban and rural population. Prevalence of symptomatic PAD was low. Diabetes, hypertension, high cholesterol, low high-density lipoprotein cholesterol, sedentary life style and smoking was observed in 25.5%, 62.9%, 61.6%, 35.9% 38.1% and 30.7%, respectively. On multivariate analysis age, smoking and physical inactivity were strong predictors of PAD. There was independent association of PAD with definite CAD. Conclusions There was high prevalence of PAD in Kerala, driven by high prevalence of risk factors. The prevalence was equal in rural and urban population. Intermittent claudication was uncommon. Age, female gender, smoking, physical inactivity, diabetes were independent predictors for presence of PAD.

Evaluation of C-reactive protein and other inflammatory markers on acute coronary syndromes

The aim of the study is to evaluate the role of C-reactive protein [CRP], ESR, total WBC and fibrinogen in acute myocardial infarction [AMI] and in unstable angina [UA], the two very common manifestations of acute coronary syndromes [ACS]. Subjects and The present study included 100 ACS patients with age ranging from 42-60 years [mean 53 +/- 6 years], of which 35 were presented with UA a n d 65 with AMI. The study also included 25 normal subjects, age and sex matched as controls. CRP levels were elevated in both A M I [40.8 +/- 15.4mg/l] as well as in UA [32.9 +/- 17.7mg/l] patients when compared to that of the normal c o n t rols [12.6 +/- 2.8mg/l]. But the value of fibrinogen was found to be elevated significantly only in AMI patients [381.9 +/- 32.1mg%]. Other markers such as WBC and ESR were found to be elevated in both AMI and UA patients. Elevation of CRP levels can be used as adjuncts in the diagnosis of ACS

Serum free iron as a risk factor for acute myocardial infarction

Elevated serum iron levels have been proposed as a risk factor for coronary artery disease. The study is aimed at investigating the role of serum iron in the pathogenesis of acute myocardial infarction [AMI]. The study was performed in 100 Acute Myocardial Infarction [AMI] patients sub-grouped as smokers, hypertensives arid diabetics. Twenty-five normal healthy subjects were included in the study as controls. Both the patients arid the control subjects were evaluated using clinical history, dietary history and biochemical examinations. Serum malondialdehyde [MDA], which is a measure of the extent of lipid peroxidation, serum iron arid total iron binding capacity [TIBC], were determined by standard methods. We found elevated serum iron in all the three risk groups with acute myocardial infarction and among the groups, the smokers were found to have higher values compared to the other two groups. Hence, it may be used as a marker for the diagnosis of AMI. However, the TIBC values were not altered in any of the three risk groups with AMI. The lipid peroxidation, measured as the endogenous MDA levels were found to be more in smokers when compared to the other two risk groups with AMI