CORONARY ARTERY DISEASE PATTERN: A COMPARISION AMONG DIFFERENT AGE GROUPS
Abstract
Background: Angiographic studies have shown that the extent of disease and severity is less in younger population with comparatively fewer number of coronary arteries affected than that of older age groups. This study was conducted to compare the pattern of coronary artery disease (CAD) in young adults under 40 years and those more than 40 years of age with significant coronary artery disease on coronary angiography. Methods: This cross-sectional study was conducted in Angiography Laboratory of Punjab Institute of Cardiology, Lahore, from 1st April, 2013 to 1st April, 2014. Patients from Angiography Laboratory of Punjab institute of cardiology Lahore were enrolled in the study. A Joint Committee of consultants reported the coronary lesions (stenosis). Single vessel disease (SVD), Double vessel disease (DVD) and Tripple vessel disease (TVD) was noted down. Results: Out of total 400, patients of age ‰¤40 years (Group-A) were 48 (12%) and >40 years (Group-B) were 352 (88%). There were 77% male patients and 22.5% females. Mean age of patients was 52.78±10.02. Significant CAD was present in 48 (10.75%) patients of Group-A and in 306 (76.5%) patients of group-B. Frequency of SVD, DVD and TVD in Group-A was 24 (50%), 10 (20.8%) and 9 (18%) respectively while frequency of SVD, DVD and TVD in group-B was 98 (27%), 88 (25%) and 120 (34%) respectively with p-value of 0.002, 0.53 and 0.03 among SVD, DVD and TVD between the two groups. Conclusion: Young (age <40 years) patients who have coronary artery disease, have less extensive coronary artery disease, with a high incidence of angiographically normal vessels and relative paucity of left main coronary arterial involvement.
Keywords: Pattern, coronary artery disease, myocardial infarction, youngReferences
Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, et al. Heart disease and stroke statistics--2008 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2008;117:e25-146.
Lloyd-Jones D, Adams RJ, Brown TM, Carnethon M, Dai S, De Simone G, et al. Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation 2010; 121(7):948-54.
Lloyd-Jones DM, Larson MG, Beiser A, Levy D. Lifetime risk of developing coronary heart disease. Lancet 1999; 353:89-92.
American Heart Association. Heart Disease and Stroke Statistics-2005 Update. Dallas, Tex: American Heart Association; 2005.
American Heart Association: Heart Disease and Stroke statistics-2006 Update. Dallas, American Heart Association, 2006.
Gaziano TA, Bitton A, Anand S, Abrahams-Gessel S, Murphy A. Growing epidemic of coronary heart disease in low- and middle-income countries. Curr Probl Cardiol 2010;35:72-115.
Akhtar P, Saghir T, Tahir F, Saleem MD, Mulla KS et al. The Impact of age and sex in the pattern of coronary artery disease. Pak Heart J 2010;43(3):3-4.
Siddique MA, Shrestha MP, Salman M. Age Related Differences of Risk Profile and Angiographic Findings in Patients with Coronary Heart Disease. BSMMU J 2010;3(1):13-7.
Haque AFMS, Siddiqui AR, Rahman SMM, Iqbal SA, Fatema NN, Khan Z. Acute Coronary Syndrome in the Young - Risk Factors and Angiographic Pattern. Cardiovasc J 2010;2(2):175-8.
Arbab-Zadeh A, Hoe J. Quantification of coronary arterial stenoses by multidetector ct angiography in comparison with conventional angiography methods, caveats, and implications. J Am Coll Cardiol Img 2011;4(2):191-202.
Cole JH, Miller JI 3rd, Sperling LS, Weintraub WS. Long-term follow-up of coronary artery disease presenting in young adults. J Am Coll Cardiol 2003; 41:521-8.
Saghir T, Qamar N, Sial J. Coronary Angiographic characteristics of Coronary artery diseasein young adults under age forty compared to those over age forty. Pak Heart J 2008;41(3-4):49-56.
Shah SS, Noor L, Shah SH, Shahsawar, Din SU, Awan ZA, et al. Myocardial Infarction in Young versus Older Adults: Clinical characteristics and Angiographic features. J Ayub Med Coll Abbottabad 2010;22(2):187-90.
Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115(5):e69-171.
American Heart Association: Heart Disease and Stroke statistics-2006 Update. Dallas, American Heart Association, 2006.
Nishtar S, Khan IS, Ahmed N, Mattu MA. Coronary artery disease burden in Pakistanis - A Review. J Pak Inst Med Sci 2001;8-12:592-4.
Jafar TH, Qadri Z, Chaturvedi N. Coronary artery disease epidemic in Pakistan: more electrocardiographic evidence of ischaemia in women than in men. Heart 2008;94:408-13.
Akanda MAK, Ali SY, Islam AEMM, Rahman MM, Parveen A, Kabir MK et al. Demographic Profile, Clinical Presentation & Angiographic Findings in 637. Patients with Coronary Heart Disease. Faridpur Med Coll J 2011;6(2):82-5.
Boden WE, O'rouke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk W et al. The evolving pattern of coronary artery disease in the US and Canada: Baseline characteristics of the clinical outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial. Am J Cadiol 2007;99:208-12.
Yildirim N, Arat N, Doğan MS, Sökmen Y, Ozcan F. Comparison of traditional risk factors, natural history and angiographic findings between coronary heart disease patients with age <40 and e40 years old. Anadolu Kardiyol Derg, 2007;7:124-7.
Wolfe MW, Vacek JL. Myocardial infarction in the young: angiographic features and risk factor analysis of patients with myocardial infarction at or before the age of 35 years. Chest 1988;94:926-30.
Shah I, Faheem M, Hafizullah M. Clinical Profile, Angiographic Characteristics and Treatment Recommendations in Patients with Coronary Artery Disease. J Pak Med Stud 2013;3(2):94-100.
Ahmed M, Baloch DJ, Memon F, Khan MU, Ali MSA. Pattern of coronary atherosclerosis in smokers and non-smokers. Pak Heart J 2003;36:20-5.
Noor L, Shah SS, Adnan Y, Sawar S, ud Din S,Amina, et al. Pattern of coronary artery disease with no risk factors under age 35 years. J Ayub Med Coll Abbottabad 2010; 22(4).
Zimmerman FH, Cameron A, Fisher LD, Ng G. Myocardial infarction in young adults: Angiographic characterization, risk factors and prognosis(Coronary Artery Surgery Registry). J Am Coll Cardiol 1995;26(3):654-61.
Sánchez Calle JM, de Mora MartÃn M, Hernández JM, GarcÃa Peña R, Guillén A, Malpartida F. Acute myocardial infarction in young adults: analysis of risk factors and coronary angiography. Arch Inst Cardiol Mex 1991;61:225-9.
Shaikh MY, Ahmad M, Rasheed A, Jan DM, Ali M. Left Main Disease-Patient Profile. Pak Heart J 2007;40:19-23
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
