Title: Clinical and Angiographic Profile of Suspected Coronary Artery Disease Patients in Central India
Authors: Prof. Dr. B. S. Yadav (DM), Dr Saket S. Khetan, Prof. Dr T. N. Dubey (DM)
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.144
Abstract
Introduction: Coronary artery disease (CAD) is a leading cause of mortality worldwide and by the year 2020, will be first in the leading causes of disability. While the death rates have been declining for the past 3 decades in the west, these rates are rising in India.
Material and Methods: This observational study consisting of 200 subjects aimed to clarify the clinical and angiographic profile of suspected CAD patients. Following factors were analysed: age, sex, menopausal status, hypertension, diabetes mellitus, dyslipidemia, tobacco chewing, smoking, CRP, obesity, serum uric acid, family history of premature CAD, thyroid profile, USG abdomen for fatty liver and gallstones, ECG and CAG.
Results: The study consisted of 71% males and 29% females. Dyslipidemia (77%) was the most common risk factor followed by obesity (62%) and HTN (50%) while 32.5% were diabetics. Elevated serum uric acid (39.5%), fatty liver (20%) and gall stones (3%); subclinical (17.5%) and overt hypothyroidism (7%) were also highly prevalent. Significant correlation between independent risk factors with severity of CAD is found with Age, Diabetes mellitus, Thyroid abnormality and serum uric acid. The correlation failed to reach statistical significance between other variables.
Conclusion: This study confirms that along with traditional risk factors like Age, male gender,menopause, diabetes, HTN, obesity, smoking the new factors like hypothyroidism, serum uric acid, CRP, fatty liver and gallstones also play a significant role in the pathogenesis of severe CAD which if modified and treated timely can prevent the ruthless assault of severe CAD in young Indians.
Keywords: Angiography, CAD, CAG, CRP, Risk Factors, ECHO, ECG.
References
1. American Heart Association/ American Stroke Association statistical data on highlights of acute coronary syndrome, 2005
2. Murray CJ Lopez AD. Mortality by cause for eight regions of the world: global burden of Disease Study. Lancet 1997;349;1269-76.
3. Bulatao RA, Stephens PW. 1992. Global estimates and projections of mortality by cause, 1970-2015. Preworking paper 1007. Washington: Population Health and Nutrition Department, World Bank.
4. Enas EA, Yusuf S, Mehta JL,. Prevalence of coronary artery disease in asian Indians.Am J Cardiol 1992;70:945-9.
5. Deedwania P, Singh . Coronary artery disease in South Asians: evolving strategies for treatment and prevention. Indian Heart J 2005;57:617-31.
6. Gupta R, Gupta VP. Meta-analysis of coronary heart disease prevalence in India. Indian Heart J 1996;48:241-5.
7. Enas EA, Dhawan J, Petkar S. 1996. Coronary artery disease in Asian Indians: lessons learnt and the role of lipoprotein-a. Indian Heart J, 49:25–34.
8. Enas EA, Garg A, Davidson MA, Nair VM, Huet BA, Yusuf S. Coronary heart disease and its risk factors in first-generation immigrant Asian Indians to the United States of America. Indian Heart J 1996;48:343-53.
9. Gupta R. Burden of coronary heart disease in India. Indian Heart J. 2005;57:632–638. [PubMed]
10. Ghaffar A., Reddy K.S., Singhi M. Burden of non-communicable diseases in South Asia (Rapid Response) BMJ.2004; 328:807–81
11. Demographic profile and prevalence of risk factors and their correlation with STEMI, NSTEMI and premature CAD in documented CAD patients 1 2 3 4 Sharad Gupta, DM , Vitull K. Gupta, MD , Rupika Gupta, MD , Sonia Arora, MBBS , Varun Gupta 5 MBBS . J. Preventive Cardiology Vol. 1 No. 4 May 2012
12. Jalowiel D.A., Hill J.A.; Myocardial infarction in the young and in women. Cardiovasc Clin. 20 1989:197-206.
13. Haastrup B, Rohold A, Larsen S et al. Prevalence of dyslipidemiain patients admitted for coronary angiography. Atherosclerosis.1995;115:34-34(1)
14. PENALVA, Rafaela Andrade et al. Lipid profile and intensity of atherosclerosis disease in acute coronary syndrome. Arq. Bras. Cardiol. [online]. 2008, vol.90, n.1 [cited 2016-09-24], pp.24-30.
15. Distribution of coronary artery disease severity and risk factors in Afro-Caribbeans Laurent Lariflaa, , b, , , Christophe Armandb, c, Fritz-Line Velayoudom-Cephiseb, Guy Weladjia, Carl Thony Michela, Anne Blanchet-Deverlyb, Jacqueline Deloum-eauxb, Lydia Foucanb http://dx.doi.org-/10.1016/j.acvd.2014.03.003
16. Mahadeva Swamy BC, Sydney C D’Souza, Kamath P (2014) Comparison of Severity of Coronary Artery Disease in Diabetic and Non-Diabetic Subjects using Gensini Score in Indian Subjects. J Diabetes Metab 5:469 doi:10.4172/2155-6156.1000469.
Banerjee A , Lim CC , Silver LE , Heneg-han C , Welch SJ , Mehta Z , Banning AP , Rothwell PM Centre for Cardiov-ascular Sciences, University of Birmingham, United Kingdom.
18. Alper AT, Hasdemir H, Sahin S, Ontürk E, Akyol A, Nurkalem Z, et al. The relationship between nonalcoholic fatty liver disease and the severity of coronary artery disease in patients with metabolic syndrome. Turk Kardiyol Dern Ars 2008; 36: 376-381.
19. Chao X, Ling B. GW25-e4543 The relationship of thyroid function and the severity of coronary artery in patients with coronary artery disease. J Am Coll Cardiol. 2014;64(16_S):. doi:10.1016/j.jacc. 2014.06.562.
20. Duran M1, Kalay N, Akpek M, Orscelik O, Elcik D, Ocak A, Inanc MT, Kasapkara HA, Oguzhan A, Eryol NK, Ergin A, Kaya MG High levels of serum uric acid predict severity of coronary artery disease in pati-ents with acute coronary syndrome Angio-logy. 2012 Aug;63(6): 448-52. doi: 10.11-77/0003319711426868.Epub 2011 Nov.
21. Relationship of high sensitivity C-reactive protein with presence and severity of coronary artery disease Syed Shahid Habib, Abeer A. Al Masri Pak J Med Sci. 2013 Nov-Dec; 29(6): 1425–1429. PMCID: PMC3905368