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Coronary artery disease common among coronary angiography patients

Tristan Manalac
29 May 2019

Coronary artery disease (CAD) is prevalent among patients who have undergone coronary angiography, according to a new Philippine study presented at the recently concluded 2019 Congress of the Asian Pacific Society of Cardiology (APSC 2019). However, the obtained rates remain lower than that in other Asian countries.

“We determined the prevalence of CAD among young adult patients who underwent coronary angiography in a single, level III private hospital from June 1, 2009 to July 31, 2018,” said researchers.

In the study population of 150 patients (mean age, 34.54±3.82 years; 80 percent male), obesity, smoking, hypertension, dyslipidaemia and diabetes were the most common risk factors. Almost a third (30.6 percent; n=46) underwent coronary angiography for acute coronary syndrome (ACS) and half of these patients had ST-elevation myocardial infarction. [APSC 2019, poster 23]

More than half (58.7 percent; n=88) of the patients were positive for CAD, most of which were cases of obstructive CAD (48 percent; n=72). In comparison, 17 participants (11.3 percent) had nonobstructive CAD and 61 (40.7 percent) had normal coronary arteries.

In those with obstructive CAD, single-vessel involvement was most prevalent (52.6 percent; n=38), followed by two- (25 percent; n=18) and three- (22 percent; n=16) vessel disease. In terms of the specific vessel, the left anterior descending vessel was most commonly involved (77.8 percent; n=56) followed distantly by the right coronary artery (43.1 percent; n=31) and left circumflex (34.7 percent; n=25) vessels.

Involvement of the posterolateral artery and ramus intermedius (4.2 percent; n=3 each) vessels was the rarest.

In participants with nonobstructive CAD, more than half had luminal irregularities (52.9 percent; n=9) while 41.2 percent (n=7) had <50-percent stenosis. One patient in this group had 50–60-percent stenosis.

In terms of treatment, percutaneous coronary intervention (PCI) was the modality of choice for obstructive CAD patients (79.2 percent; n=57). On the other hand, 19.4 percent (n=14) received medical therapy while one participant (1.4 percent) underwent coronary artery bypass grafting.

“Majority of patients diagnosed with obstructive CAD underwent PCI and had good in-hospital outcomes,” said researchers. They had all-cause, cardiovascular and noncardiovascular mortality rates of 2 percent, 1.3 percent and 0.67 percent, respectively.

“Since CAD in young adults is associated with poor prognosis with mortality rate as high as 30 percent in 15 years, identifying the prevalence as well as risk factors in the development [of] CAD in … young adult Filipino patients may help in early recognition of the disease and aggressive risk factor modification among patients-at-risk,” researchers added.

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