Pakistan study of premature coronary atherosclerosis in young adults (pak-sehat): A prospective longitudinal study protocol investigating the prevalence, severity and determinants of atherosclerotic cardiovascular disease in the young adult pakistani population

Bashir Hanif, Tabba Heart Institute, Karachi, Sindh, Pakistan
Sana Sheikh, Tabba Heart Institute, Karachi, Pakistan
Ghazal Peerwani, Hospital del Mar, Barcelona, Spain
Miguel Cainzos Achirica, Institut Hospital del Mar d'Investigacions Mediques, Barcelona, Spain
Wajiha Javed, Public Health, Getz Pharma, Karachi, Pakistan
Jaffer Bin Baqar, Public Health, Getz Pharma, Karachi, Pakistan
Zainab Samad, Aga Khan University
Faiza Bashir, Department of Medicine, Ziauddin Medical University, Karachi, Pakistan
Salim S. Virani, Aga Khan University
Khurram Nasir, Department of Medicine, Houston Methodist, Houston, Texas, USA
Saba Aijaz, Cardiology, Clinical Research Cardiology, Tabba Heart Institute, Karachi, Pakistan

Pagination are not provided by the author/publisher.


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 prematurely 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 event
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.