Prevalence and pattern of coronary artery disease in young women as per Angiography: A Cross sectional study
Abstract
Coronary artery disease (CAD) is the most common cause of mortality in India. Deaths due to CAD occur 5–10 years earlier in the Indians than in Western countries. Coronary artery disease (CAD) in young women, who are previously considered as low risk group, is on rise now due to various reasons. This study is aimed to find out the prevellance of CAD in young women admitted for evaluation of chest pain. The data of women suspected to have CAD and underwent cardioangiography (CAG) over a period of 1 year was analyzed. The discharge summaries, coronary angiograms and angiogram reports were studied to get information about clinical and angiographic profiles of these women in the “young group” (age < 55 years). Study showed normal epicardial coronaries in 37.5 % of women, nonsignificant lesion in 19% women and intermediate lesion in 10% women and obstructive CAD in 33.5 % of women. There were 18 % women with SVD, 13 % women with DVD and 2.5% women with TVD. Study concludes that there is an alarming increase in the proportion of young women angiographically diagnosed to have significant coronary artery disease.
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Introduction
Coronary artery disease (CAD) is a major cause of death. 1 The incidence of CAD has drastically comedown in the developed nations, but it has increased substantially in developing countries. 2 CAD in our subcontinent is different from that of western countries i.e, it occurs at relatively younger age. 2 Major risk factors predispose to CAD in 2% of 15–19 years old and 20% of 30 - 34 years men and 8% of women in 30 – 34 years of age. It can be clearly understood that early atherosclerosis is modified by the risk factors for clinical CAD. Hence long term prevention must begin as early as 30-35 years of age3 for risk factors like metabolic syndrome 4, 6 obesity5 and Dyslipidemia. 7
Prevalence and pattern of CAD in young women is not well studied in various studies. There is not enough data for angiographic prevalence as well as pattern of CAD in young women. It is a well known fact that the prevalence of CAD is more in men compared to women. Some earlier data showed that among women who undergo coronary angiogram (CAG) the angiographically determined prevalence of “single vessel disease” (SVD) is 5.77%, “double vessel disease” (DVD) is 3.15%, and “triple vessel disease” (TVD) is 2.8 % respectively. 8, 9 With more than two risk factors, significant CAD is seen in 21% of women10 study done by Dave et al among Indian women undergoing coronary angiography showed greater proportion of TVD (39.6%) than DVD (12.9%) or SVD (15.8%).
This present study is intended to know about the angiographic prevalence and pattern of CAD in young women admitted for coronary angiogram in a tertiary care hospital.
Conclusion
This present study concluded that the major modifiable risk factors in our young adults are Hypertension, diabetes and Dyslipidemia. The clustering of risk factors particularly two or more risk factors in an individual predispose to CAD at relatively younger age. There is an alarming increase in the proportion of young women angiographically diagnosed to have significant coronary artery disease. There has been a change with regard to clinical presentation and onset of risk factors for coronary artery disease at young age, but the load of atherosclerotic plaque burden and type of involvement of coronary arteries have not changed in women.