An investigation into the relationship of insulin and other related biochemical parameters with coronary artery disease in a south indian population

Abstract

Coronary artery disease (CAD) is the leading cause of death worldwide. It has reached enormous proportions striking more and more at younger subjects and has transformed as the greatest epidemic that mankind has ever-faced. Moreover, people hailing from Indian subcontinent have a higher probability of dying due to CAD. In the past three decades, CAD rates have doubled in rural areas and tripled in urban areas of India (Chopra and Wasir, 1998; WHO, 2009). This alarming trend has to be reversed by intense research into its cause and prevention. CAD occurs when the arteries that supply blood to the heart muscle, harden and narrow (Bhati, 2011; Heart diseases, 2011). This results in the loss of oxygen and nutrients to myocardial tissue because of diminished coronary blood flow. The reduction in blood flow can lead to acute coronary syndrome. Atherosclerosis is the usual cause of CAD. In this condition (Figure 1), fatty, fibrous plaques (Figure 2), including calcium deposits, narrow the lumen of the coronary arteries; thereby reducing the volume of blood flowing through them, and leading to myocardial ischemia. Plaque formation (Figure 3) also predisposes to thrombosis, which can provoke myocardial infarction (MI) (Lippincott and Wilkins, 2005). Atherosclerosis usually develops in high-pressure arteries, such as those in the heart, brain, kidneys, and in the aorta, especially at bifurcation points.