Speaker Abstract

Premature Coronary Artery Disease (CAD) Is a Major Public Health Problem for Asian Indians

Prakash C. Deedwania, VACCHCS, Fresno, CA; UCSF School of Medicine, San Francisco, CA, USA.

It is now well established that AI have one of the highest incidences of CAD and its manifestation in the third and fourth decades of their life. In the vast majority of AI, the initial manifestation of CAD is often myocardial infarction. Furthermore, once CAD is clinically manifested, it is usually advanced and diffuse, so it is not amenable to revascularization procedures. The evaluation of coronary risk factors in AI with CAD has revealed that often traditional risk factors such as hypertension and hypercholesterolemia are not contributing factors. In contrast, a number of studies have demonstrated a high prevalence of diabetes and related metabolic abnormalities (e.g., low HDL, high triglycerides) in AI with CAD. Although more work is needed, the available data suggest that insulin resistance might be playing a key role in the pathogenesis of premature CAD in AL The precise reason(s) for the high prevalence of diabetes and insulin resistance is not known; however, it may be related to complex geneenvironment interactions. In order to avoid the emerging epidemic of premature CAD, there is an urgent need to define the pathophysiologic and genetic aspects of diabetes and insulin resistance in Al.