STUDY OF RISK FACTORS, CLINICAL PROFILES AND ANGIOGRAPHIC PATTERNS IN PATIENTS OF CORONARY ARTERY DISEASE IN A TERTIARY CARE CENTRE IN CHHATTISGARH

Abstract

BACKGROUND Deaths due to Cardiovascular Disease (CVD) accounted for 30.8\% of all deaths, i.e. 18.1 million deaths by 2010 and estimated to be 32.5\% of all deaths, i.e. 24.2 million deaths by 2030 globally. In 2000, there were an estimated 29.8 million people with cardiovascular disease in India out of a total estimated population of 1.03 billion or a nearly 3\% overall prevalence. It is estimated that there were approximately 46.9 million people with cardiovascular disease in India during 2010, of which 2.33 million people succumbed. Considering the increasing burden of atherosclerotic disease and its mortality and also the usefulness of finding risk factors, studying the clinical profile and angiographic pattern will help us to fight the progression of the disease by intervening at various levels which can decrease the morbidity and mortality due to cardiovascular disease. MATERIALS AND METHODS The present study was conducted in the Department of Medicine, Dr. B.R.A.M Hospital during the period of 2014 - 2016. This is a hospital-based observational prospective study with prospective data collection, where all patients of coronary artery disease () who had undergone coronary angiography has been taken into consideration to find out the risk factors, clinical profiles and angiographic patterns in coronary artery disease patients in Chhattisgarh. RESULTS Maximum patients were present in the age group of 41 - 50 yrs., mean age being 55 years +/- 12.11 sd. Male patients were 79.4\% and 20.58\% were female patients. The most common symptom was chest pain, 82.35\% patients had it at the time of presentation. The next frequent symptom was breathlessness, 53.92\% patients had it; 42.15\% patients had sweating and 24.5\% patients had palpitations. Among the risk factors, 41.1\% had hypertension and 33.3\% had sedentary lifestyle. On examination 61.7\% patients had obesity defined by BMI > 25 and a total of 41.1\% patients had hypertension; 24 patients had ABI < 0.9 indicating PAD i.e. 23.52\% in the study had PAD as visualised by CAG, 39.2\% patients had SVD, 20.58\% patients had DVD and 14.7\% had TVD; 8.8\% patients had non- significant coronary artery disease; 16.66\% patients had recanalised epicardial coronaries. Among 40 patients of SVD, 2 (5\%) had ABI < 0.9. Among 21 patients of DVD, 11 (47.6\%) had ABI < 0.9. Among 15 patients of TVD, 12 (80\%) had ABI < 0.9. None of the patients with non- significant coronary artery disease and normal coronaries had ABI < 0.9. LAD was involved in 49 patients (48.2\%), RCA was involved in 30 (29.2\%) patients and LCX was involved in 20 (19.6\%) patients. The frequency of LAD involvement was maximum followed by RCA and then LCX; 24 (100\%) patients who had ABI < 0.9 also had angiographic proven coronary artery disease. Of 78 patients who had ABI > 0.9, 52 (66.7\%) patients had significant coronary artery disease. Of 76 patients of significant coronary artery disease, 24 (31.5\%) patients had ABI < 0.9. CONCLUSION Coronary artery disease, an epidemic in our country has to be tackled by preventing at each step, i.e. at the level of risk factors so that the morbidity and mortality of the disease can be curtailed.