Original Article

Factors associated with the incidence of coronary heart disease in the MASHAD cohort study: A six years follow up



Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally, and specifically in Iran. Accurate assessments of Coronary heart disease (CHD) incidence is very necessary for public health. In current study we aimed to investigate the incidence of CHD and

importance of several classical, modifiable and un-modifiable risk factors for CHD among an urban population in eastern Iran after 6 years of follow-up.


The population of MASHAD cohort study were followed up for 6 years, every 3 years in two step by phone and who reported symptoms of CVD were asked to attend for a cardiac examination, to estimate the incidence of CHD with 95% confidence interval (95% CI) as well multiple logistic regression analysis was performed to assess the association of several baseline characteristics with incidence of CHD event. Evaluation of goodness-of-fit was done using ROC analysis. CHD cases divided into four different classes which include: stable angina, unstable angina pectoris, myocardial infarction and sudden cardiac death.

Results In the six years' follow-up of Mashhad study, the incidence rate of all CHD event in men and women in 100,000 people-years with 95% confidence intervals were 1920 (810-3030) and 1160 (730-1590), respectively. The areas under ROC curve (AUC), based on multivariate predictors of CHD outcome, was 0.7825. Conclusion

Our findings indicated that the incidence rate of coronary heart diseases in MASHAD cohort study increases with age as well as our final model designed, was able to predict approximately 78% of CHD events in Iranian population.


1. Darroudi S, Tajbakhsh A, Esmaily H, Ghazizadeh H, Zamani P, Sadabadi F, et al. 50 bp deletion in promoter superoxide dismutase 1 gene and increasing risk of cardiovascular disease in Mashhad stroke and heart atherosclerotic disorder cohort study. Biofactors. 2020;46(1):55-63.
2. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Executive summary: heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;129(3):399-410.
3. MEMBERS WG, Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, et al. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28.
4. Maseri A, Chierchia S, Davies G. Pathophysiology of coronary occlusion in acute infarction. Circulation. 1986;73(2):233-9.
5. Members WG, Thom T, Haase N, Rosamond W, Howard VJ, Rumsfeld J, et al. Heart disease and stroke statistics—2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113(6):e85-e151.
6. Kharazmi-Khorassani J, Ghazizadeh H, Zare-Feyzabadi R, Kharazmi-Khorassani S, Naji-Reihani-Garmroudi S, Kazemi E, et al. The role of serum monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) in cardiovascular disease risk. Acta Bio-medica: Atenei Parmensis.2021;92(2):e2021049-e.
7. Sadabadi F, Gholoobi A, Heidari-Bakavol A, Mouhebati M, Javandoost A, Asadi Z, et al. Decreased Threshold of Fasting Serum Glucose for Cardiovascular Events: MASHAD Cohort Study. Reports of Biochemistry & Molecular Biology. 2020;9(1):64.
8. O'Donnell CJ, Elosua R. Cardiovascular risk factors. Insights from framingham heart study. Revista Española de Cardiología (English Edition). 2008;61(3):299-310.
9. Hatmi Z, Tahvildari S, Motlag AG, Kashani AS. Prevalence of coronary artery disease risk factors in Iran: a population
based survey. BMC cardiovascular disorders.2007;7(1):32.
10. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Investigators IS. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-52.
11. Nozari Y, Hashemlu A, Hatmi ZN, Sheikhvatan M, Iravani A, Bazdar A, et al. Outcome of coronary artery bypass grafting in patients without major risk factors and patients with at least one major risk factor for coronary artery disease. Indian journal of medical sciences. 2007;61(10):547-54.
12. Talaei M, Sarrafzadegan N, Sadeghi M, Oveisgharan S, Marshall T, Thomas GN, et al. Incidence of cardiovascular diseases in an Iranian population: the Isfahan Cohort Study. Archives of Iranian medicine. 2013;16(3):0-.
13. Hadaegh F, Harati H, Ghanbarian A,Azizi F. Prevalence of coronary heart disease among Tehran adults: Tehran Lipid and Glucose Study. 2009.
14. Khalili D, Sheikholeslami FH, Bakhtiyari M, Azizi F, Momenan AA, Hadaegh F.The incidence of coronary heart disease and the population attributable fraction of its risk factors in Tehran: a 10-year population-based cohort study. PloS one. 2014;9(8).
15. Ghayour-Mobarhan M, Moohebati M, Esmaily H, Ebrahimi M, Parizadeh SMR, Heidari-Bakavoli AR, et al. Mashhad stroke and heart atherosclerotic disorder (MASHAD) study: design, baseline characteristics and 10- year cardiovascular risk estimation. International journal of public health. 2015;60(5):561-72.
16. Organization WH. International Statistical Classification of Diseases and RelatedHealth Problems: Alphabetical index: World Health Organization; 2004.
17. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source code for biology and medicine. 2008;3(1):1-8.
18. Roger VL. Epidemiology of myocardial infarction. Medical Clinics of North America. 2007;91(4):537-52.
19. Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. European heart journal. 2014;35(42):2950-9.
20. Ghazizadeh H, Kathryn Bohn M, Ghaffarian Zirak R, Kamel Khodabandeh A, Zare‐Feyzabadi R, Saberi‐Karimian M, et al.Comprehensive laboratory reference intervals for routine biochemical markers and pro‐oxidant‐ antioxidant balance (PAB) in male adults. Journal of Clinical Laboratory Analysis. 2020;34(11):e23470.
21. Members WG, Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, et al. Executive summary: heart disease and
stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125(1):188-97.
22. Hinton W, McGovern A, Coyle R, Han TS, Sharma P, Correa A, et al. Incidence and prevalence of cardiovascular disease in English primary care: a cross-sectional and followup study of the Royal College of General Practitioners
(RCGP) Research and Surveillance Centre (RSC). BMJ open. 2018;8(8):e020282.
23. Iso H. A Japanese health success story: trends in cardiovascular diseases, their risk factors, and the contribution of public health and personalized approaches. Epma Journal. 2011;2(1):49-57.
24. Available from: https://www.who.int/ cardiovascular_diseases/en/.
25. Steyerberg EW, Van Calster B, Pencina MJ. Performance measures for prediction models and markers: evaluation of predictions and classifications. Revista Española de Cardiología (English Edition). 2011;64(9):788-94.
26. Voss R, Cullen P, Schulte H, Assmann G. Prediction of risk of coronary events in middle-aged men in the Prospective Cardiovascular Münster Study (PROCAM) using neural networks. International journal of epidemiology.2002;31(6):1253-62.
27. Liao Y, McGee DL, Cooper RS. Prediction of coronary heart disease mortality in blacks and whites: pooled data from two national cohorts. The American journal of cardiology. 1999;84(1):31-6.
IssueVol 8 No 2 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jbe.v8i2.10414
Mashhad Cohort study Incidence Coronary disease Multiple analysis

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Sadabadi F, Moohebati M, Heidari-Bakavoli A, Darroudi S, Nazarpour S, Khorrami Mohebbseraj MS, Asadi Z, Esmaeily H, Ghazizadeh H, Barati E, malekzadeh Gonabadi N, Samadi S, Tayefi M, Izadi mood Z, Azarpazhooh MR, Heidari- Bakavoli S, Hoori T, Bahramizadeh Sajjadi R, Ferns G, Mobarhan MG, Miri HH. Factors associated with the incidence of coronary heart disease in the MASHAD cohort study: A six years follow up. JBE. 2022;8(2):160-169.