Prevalence of Coronary Atherosclerosis and associated Factors Among adult Population in Addis Ababa, Ethiopia: Autopsy based Cross Sectional Study

Abstract

Summary Background: Atherosclerosis has been a human disease for more than 3,500 years; it occurred in Egyptian mummies and showed the same pathologic features that are observed in modern times age. It is a pathologically diverse disease with heterogeneous mechanisms of progression. Moreover, it is a complex process involving inflammation and cellular proliferation in the arterial wall that is mediated by a variety of growth factors, cytokines, thrombotic factors, and vasoactive molecules. CVDs are a cluster of diseases and injuries that affect the cardiovascular system and supporting structures. The main CVDs include (but are not limited to) coronary heart disease, congestive heart failure, angina, peripheral arterial disease, deep vein thrombosis (DVT), and stroke. In low- and middle-income countries, cardiovascular diseases have become an emerging issue for several reasons: over 80% of the world’s deaths for CVD occur in low and middle income countries; people in these countries are more exposed to risk factors leading to CVD and other noncommunicable diseases and are less exposed to prevention efforts than people in high income countries; in these countries people who suffer from CVD have less access to effective and equitable health care services which respond to their. Our study has major relevance of illustrate the increasing contribution of noncommunicable diseases to morbidity and mortality in low-income countries like Ethiopia. Methods: All deceased adult brought to the SPHMMC autopsy facility from 8 may 2023 to 30 October 2023 that fulfilled the inclusion criteria was included in this study. An autopsy based prospective cross sectional study design was employed. A semi-structured checklist from reviewed literatures was developed in English by the principal investigator and it was used to collect the autopsy, pathology report and informant data. Data was was exported to SPSS version 26 for analysis. Summary statistics was used to describe the population. The prevalence of coronary atherosclerosis was evaluated by various socio-demographic and behavioral characteristics and co-morbidities. After that the binary logistic regression model was used to assess the association between dependent and independent variables for each outcome. A variable with a p-value of less than 0.25 was considered for multivariable logistic regression analysis. In the multivariable analysis, a p-value of less than 0.05 and an odds ratio with 95% CI was used to declare the presence and the strength of association between the independent and outcome variable. Work plan and budget: The study was conducted from 1 July, 2023 to 9 December, 2023. with an estimated budget of ETB 31,675. Key words: CVD, CAD, Atherosclerosis, Autopsy, prevalence,