Abstract
BACKGROUND Although the burden of premature myocardial infarction (MI) is high in Malaysia, direct evidence on the determinants of MI in this multi-ethnic population remains sparse. OBJECTIVE The Malaysian Acute Vascular Events Risk (MAVERIK) study is a retrospective case-control study established to investigate the genomic, lipid-related, and other determinants of acute MI in Malaysia. In this paper, we report the study protocol and early results. METHODS By June 2019, we had enrolled approximately 2500 patients with their first MI and 2500 controls without cardiovascular disease, who were frequency-matched by age, sex, and ethnicity, from 17 hospitals in Malaysia. For each participant, serum and whole blood have been collected and stored. Clinical, demographic, and behavioral information has been obtained using a 200-item questionnaire. RESULTS Tobacco consumption, a history of diabetes, hypertension, markers of visceral adiposity, indicators of lower socioeconomic status, and a family history of coronary disease were more prevalent in cases than in controls. Adjusted (age and sex) logistic regression models for traditional risk factors indicated that current smoking (odds ratio [OR] 4.11, 95% CI 3.56-4.75; P<.001), previous smoking (OR 1.34, 95% CI 1.12-1.60; P=.001), a history of high blood pressure (OR 2.13, 95% CI 1.86-2.44; P<.001), a history of diabetes mellitus (OR 2.72, 95% CI 2.34-3.17; P<.001), a family history of coronary heart disease (OR 1.28, 95% CI 1.07-1.55; P=.009), and obesity (BMI >30 kg/m2; OR 1.19, 95% CI 1.05-1.34; P=.009) were associated with MI in age- and sex-adjusted models. CONCLUSIONS The MAVERIK study can serve as a useful platform to investigate genetic and other risk factors for MI in an understudied Southeast Asian population. It should help to hasten the discovery of disease-causing pathways and inform regionally appropriate strategies that optimize public health action. INTERNATIONAL REGISTERED REPORT RR1-10.2196/31885
Keywords myocardial infarction · risk factors · smoking · hypertension · diabetes mellitus · obesity · family history of coronary heart disease · visceral fat · socioeconomic status · genetic factors
Cite this paper
Rajiv Chowdhury, Mohd Fairulnizal Md Noh, Sophia Rasheeqa Ismail, Kim Robin van Daalen, Puteri Sofia Nadira Megat Kamaruddin, Siti Hafizah Zulkiply, Nur Hayati Azizul, Norhayati Mustafa Khalid, Azizan Ali, Izyan Mohd Idris, Yong Shih Mei, Shazana Rifham Abdullah, Norfashihah Faridus, Nur Azirah Md Yusof, Nur Najwa Farahin M Yusoff, Rahman Jamal, Aizai Azan Abdul Rahim, Abdul Kahar Abdul Ghapar, Ammu Kutty Radhakrishnan, Alan Yean Yip Fong, Omar Ismail, Saravanan Krishinan, Chuey Yan Lee, Liew Houng Bang, Eashwary Mageswaren, K. Mahendran, N.H. Mohd Amin, Gunavathy Muthusamy, Aaron Ong Hean Jin, Ahmad Wazi Ramli, Noel Thomas Ross, Anwar Irawan Ruhani, Mansor Yahya, Yusniza Yusoff, Siti Khairani Zainal Abidin, Laryssa Amado, Thomas Bolton, Sophie Weston, Jason Crawte, Niko Ovenden, Ank Michielsen, Md Mostafa Monower, Wan Rozita Wan Mahiyuddin, Angela Wood, Emanuele Di Angelantonio, Nur S. Sulaiman, John Danesh, & Adam S. Butterworth. (2021). Investigating Genetic and Other Determinants of First-Onset Myocardial Infarction in Malaysia: Protocol for the Malaysian Acute Vascular Events Risk Study. JMIR Research Protocols, 11(2), e31885. https://doi.org/10.2196/31885
Authors and affiliations
Rajiv Chowdhury
University of Cambridge
ORCID 0000-0003-4881-5690Mohd Fairulnizal Md Noh
Ministry of Health
ORCID 0000-0001-6960-0774Sophia Rasheeqa Ismail
Ministry of Health
ORCID 0000-0002-4271-0241Kim Robin van Daalen
University of Cambridge
ORCID 0000-0001-6955-9708Puteri Sofia Nadira Megat Kamaruddin
Ministry of Health
ORCID 0000-0002-1499-8583Siti Hafizah Zulkiply
Ministry of Health
ORCID 0000-0003-0859-5080Nur Hayati Azizul
Ministry of Health
ORCID 0000-0003-1443-1074Norhayati Mustafa Khalid
Ministry of Health
ORCID 0000-0002-3310-1305Azizan Ali
Ministry of Health
ORCID 0000-0002-5014-282XIzyan Mohd Idris
Ministry of Health
ORCID 0000-0001-5115-1667Yong Shih Mei
Ministry of Health
ORCID 0000-0001-8383-0082Shazana Rifham Abdullah
Ministry of Health
ORCID 0000-0002-7503-5895Norfashihah Faridus
Ministry of Health
ORCID 0000-0002-6246-2169Nur Azirah Md Yusof
Ministry of Health
ORCID 0000-0001-6422-6365Nur Najwa Farahin M Yusoff
Ministry of Health
ORCID 0000-0002-8544-7690Rahman Jamal
University Kebangsaan Malaysia Medical Centre
ORCID 0000-0002-8354-8957Aizai Azan Abdul Rahim
National Heart Institute
ORCID 0000-0003-1688-4018Abdul Kahar Abdul Ghapar
Serdang Hospital
ORCID 0000-0002-2136-0836Ammu Kutty Radhakrishnan
Monash University Malaysia
ORCID 0000-0003-2638-907XAlan Yean Yip Fong
Sarawak General Hospital
ORCID 0000-0002-6675-1312Omar Ismail
Hospital Pulau Pinang
ORCID 0000-0002-3015-0582Saravanan Krishinan
Hospital Sultanah Bahiyah
ORCID 0000-0003-0196-981XChuey Yan Lee
Sultanah Aminah Hospital
ORCID 0000-0002-7706-2811Liew Houng Bang
Ministry of Health
ORCID 0000-0003-1914-3872Eashwary Mageswaren
Ministry of Health
ORCID 0000-0002-4747-8541K. Mahendran
Malacca General Hospital
ORCID 0000-0002-5535-2893N.H. Mohd Amin
Department of General Medicine, Hospital Raja Permaisuri Bainun, Perak, Malaysia
ORCID 0000-0002-5290-7507Gunavathy Muthusamy
Ministry of Health
ORCID 0000-0002-7723-3828Aaron Ong Hean Jin
Department of General Medicine, Hospital Tuanku Fauziah, Perlis, Malaysia
ORCID 0000-0001-7453-8346Ahmad Wazi Ramli
Hospital Sultanah Nur Zahirah
ORCID 0000-0002-2012-4903Noel Thomas Ross
Hospital Kuala Lumpur
ORCID 0000-0001-5561-5940Anwar Irawan Ruhani
Hospital Tengku Ampuan Afzan
ORCID 0000-0001-6364-5840Mansor Yahya
Ministry of Health
ORCID 0000-0002-7098-5840Yusniza Yusoff
Hospital Sungai Buloh
ORCID 0000-0002-3002-0999Siti Khairani Zainal Abidin
Tengku Ampuan Rahimah Hospital
ORCID 0000-0002-6598-9206Laryssa Amado
Ministry of Health
ORCID 0000-0002-5070-8811Thomas Bolton
University of Cambridge
ORCID 0000-0002-2998-7975Sophie Weston
Ministry of Health
ORCID 0000-0002-1592-480XJason Crawte
Ministry of Health
ORCID 0000-0002-9330-1229Niko Ovenden
Ministry of Health
ORCID 0000-0003-0920-6630Ank Michielsen
University of Cambridge
ORCID 0000-0002-4818-1686National Heart Foundation Hospital & Research Institute
ORCID 0000-0002-1531-5633Wan Rozita Wan Mahiyuddin
Ministry of Health
ORCID 0000-0001-6302-6687Angela Wood
University of Cambridge
ORCID 0000-0002-7937-304XEmanuele Di Angelantonio
Ministry of Health
ORCID 0000-0001-8776-6719Nur S. Sulaiman
Ministry of Health
ORCID 0000-0002-1047-5371John Danesh
University of Cambridge
ORCID 0000-0003-1158-6791Adam S. Butterworth
Ministry of Health
ORCID 0000-0002-6915-9015