Inducible Nitric Oxide Synthase Gene Polymorphism and Markers of Pro-inflammatory Endothelial Dysfunction in Coronary Artery Disease: Case Control Study in North Indian Population

Author(s): Shilpa Bhardwaj, Richa Dixit, Jayashree Bhattacharjee, MK Bhatnagar, Sanjay Tyagi

Coronary Artery Disease (CAD) is a major public health issue globally and is the leading cause of death worldwide (1). According to the World Health Organization (WHO), cardiovascular diseases (CVDs), particularly CAD, are responsible for an estimated 17.9 million deaths each year, which accounts for 31% of all global deaths. The WHO projects that by 2030, nearly 23.6 million people will die annually from cardiovascular diseases. The WHO reports that India is experiencing a surge in the number of CAD cases, making it a significant public health concern (2). The age-adjusted mortality rate from CAD in India is among the highest in the world (3). According to recent statistics, the prevalence of CAD in urban India is estimated to be between 7-13%, while in rural areas, it is between 2-7%. [4]. The etiology of CAD is multifactorial and the various environmental, lifestyle, and genetic factors interact to affect the evolution and progression of the disease. Apart from traditional risk factors, chronic "low grade" inflammation mediated by macrophage and lymphocytes, has been implicated in the pathogenesis of atherosclerosis and cardiovascular events [5]. Inflammation has become one of the central themes in the pathogenesis of heart disease, over the past decade along with endothelial dysfunction, representing a key early step in the development of atherosclerosis and is also involved in plaque progression and the occurrence of atherosclerotic complications.