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Abstract
Introduction Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity, mortality and health expenditures worldwide. Despite having higher ASCVD in the Pakistani population, data on subclinical coronary atherosclerosis in young Pakistanis remain scarce. The PAKistan Study of prEmature coronary atHerosclerosis in young AdulTs (PAK-SEHAT) aims to assess the prevalence, severity and determinants of subclinical coronary atherosclerosis among Pakistani men (35–60 years) and women (35–65 years) free of clinically symptomatic ASCVD and will assess 5-year rates of ASCVD events.
Methods and analysis PAK-SEHAT is an ongoing prospective cohort study with 2000 participants from all provinces of Pakistan who will be interviewed at the baseline along with phlebotomy, measurement of carotid intima-media thickness (CIMT) and coronary CT angiography (CCTA). Phlebotomy will be repeated at 2.5 years, whereas CIMT and CCTA will be repeated at 5 years. We will report the frequency of maximal coronary stenosis ≥50% and ≥70%, number of coronary vessels with plaque and the number of coronary segments affected per participant on CCTA. We will use Cox proportional hazards regression models to evaluate the association between baseline characteristics and incident ASCVD events during follow-up. These associations will be presented as HRs with 95% CIs.
Ethics and dissemination The study protocol was approved by the Tabba Heart Institute Institutional Review Board (THI/IRB/FQ/22-09-2021/016). All study procedures are consistent with the principles of the Declaration of Helsinki. Findings of the study will be disseminated via peer-reviewed publications and conference presentations.
Trial registration number NCT05156736.
- Cardiac Epidemiology
- Coronary heart disease
- Myocardial infarction
- Adult cardiology
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Contributors BH—conceptualisation, funding acquisition, methodology, supervision and editing and reviewing the manuscript. SS—curating methodology, writing initial draft and editing and reviewing the manuscript. GP—curating methodology, writing initial draft and editing and reviewing the manuscript. MC-A—methodology, visualisation, writing initial draft and editing and reviewing the manuscript. WJ—funding acquisition, methodology, supervision and editing and reviewing the manuscript. JBB—methodology and editing and reviewing the manuscript. ZS—methodology and editing and reviewing the manuscript. FB—editing and reviewing the manuscript. SSV—curating methodology, writing initial draft and editing and reviewing the manuscript. KN—curating methodology and editing and reviewing the manuscript. SA—curating methodology, writing initial draft and editing and reviewing the manuscript. All authors approved the manuscript and this submission. SS and GP share the second authorship as per their contribution.
Funding This study is funded by our study partner Getz Pharma Private Limited (study registration number: GPPL-PH-002).
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Competing interests WJ is the head of public health and JBB is a senior manager at Getz Pharma Private Limited.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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