OUTCOME OF CORONARY ANGIOGRAMS AMONG RURAL POPULATION

Background: In India Coronary artery disease manifests almost a decade earlier than in western countries. This is a study to discuss the distribution of coronary angiograms among the patients admitted to cardiology department, Stanley Medical college. Objective: This study examined the Coronary angiographic profile of men and women admitted with a diagnosis of coronary artery disease in in our hospital with special emphasis on non obstructive CAD. Methods: The methodology used was single centre retrospective analysis. Results: Among the case that underwent CAG in our hospital 8.7% come under 20 – 40 years; 64.5 % come under 40 – 60 years and 26.8% of cases are above 60 years. Females account for 35.8% and males account 64.2%. Among CSA patients, Non obstructive CAD make up 63% of the cases. Amon UA/ NSTEMI, non obstructive CAD make up 42% of cases. Conclusion: Normal coronaries


ISSN: 2320-5407
Int. J. Adv. Res. 8(08), 682-690 683 Obstructive CAD producing symptoms is well known and a number of studies have been done to prove this. Non obstructive CAD has generally been considered to be benign and the studies based on non obstructive CAD is far fetched. Normal angiography in patients with chest pain is five times more common in women than in men. Among patients with chest pain and normal angiography, an unknown number are suffering from cardiac pain of ischemic origin.
In this study we plan to discuss the results of CAGs done in GSH with special emphasis on non obstructive CAD.

Aim :
Our objective was to study the prevalence and pattern of CAD in patients undergoing CAG from January 2018 to December 2018.

Methodology:-
The data of patients suspected to have CAD and underwent CAG over a period of 1 year from January 2018 to December 2018. The discharge summaries, coronary angiograms and angiogram reports were studied to get information about angiographic profiles. They were classified based on gender and age.
In this study, obstructive CAD was defined as at least 50% stenosis of luminal diameter of LMCA or at least 70% stenosis of luminal diameter of at least one of the major epicardial coronary arteries.
Non-significant lesion was defined as less than 50% stenosis of left main coronary arterty and less than 70% of epicardial artery. Depending on the number of major epicardial arteries involved, they are classified as SVD, DVD and TVD. Normal coronaries include myocardial bridging and slow flow. The prevalence and pattern of CAD in these patients were analysed.

Csa :
CSA patients make up around 10% of the total patients. Females make up around 60% of the CSA population with 32 % of them having normal epicardial coronaries. 5% of females have TVD. Normal coronaries make up 42% of the coronary artery distribution. Minimal CAD cases make up 21% ( males 40%, females 60%). TVD make up 12% among CSA cases with almost equal distribution among makes and females. Normal coronaries make up 42% of the total CSA cases ( males 24%, females 76%).
Patients between the age group of 40 -60 years make up majority of the cases among both the males and females. The make up 61 % of the study population. Among the normal coronaries 70% of the population are between 40 -60 years of age with female comprising more than half. Among the TVD cases males between 40 -60 years comprise more than 50% of cases and among females 70% are above 60 years of age. Ua / nstemi : UA / NSTEMI cases make up 52% of all the patients undergoing angiogram. Among the UA / NSTEMI cases patients with normal coronaries make up around 25% of the cases with more females (61%) than males (39%). Patients with TVD make up 16% of unstable angina case with male constituting the majority (76%). Patients with LM and TVD show form 5% of UA and NSTEMI cases with males being the majority ( 61%). Minimal CAD makes up 17% of UA cases with an almost equal distribution between male and females. Among single vessel diseases LAD was predominantly involved (12%) with males making up 64% and females 36%. Among the DVDs LAD and RCA is most frequently involved with 7.6% with males being involved the most ( 54%).
Among the UA/NSTEMI cases, age group between 40 -60% make up 65% of the total cases with males making up 58% and females comprising 42%. Among normal coronaries, people between the age group of 40 -60% comprise 68% with males comprising 44% and females 56%. People between the age group of 20 to 40 years comprise 20% of the total cases and people among the > 60 years comprise 12%. Among minimal CAD cases, people between the age group of 40 -60% comprise 70% with males comprising 56% and females 44%. People between the age group of 20 to 40 years comprise 8% of the total cases and people among the > 60 years comprise 22%. Among SVD of LAD cases, people between the age group of 40 -60% comprise 70% with males comprising 63% and females 37%. People between the age group of 20 to 40 years comprise 8% of the total cases and people among the > 60 years comprise 22%. Among DVD OF LAD AND LCX cases, people between the age group of 40 -60% comprise 68% with males comprising 67% and females 33%. People among the > 60 years comprise 32%.Among DVD of LAD AND RCA cases, people between the age group of 40 -60% comprise 61 % (males 81% and females 19%). People between the age group of 20 to 40 years comprise 4% of the total cases and people among the > 60 years comprise 35%. Among TVD cases, people between the age group of 40 -60% comprise 57% (males 75% and females 27%). People between the age group of 20 to 40 years comprise 5% ( males 86% females 14%) of the total cases and people among the > 60 years comprise 38% (males 77% females 23%). Among LM with TVD cases, people between the age group of 40 -60% comprise 41% (males 56% and females 44 %). People among > 60 years comprise 59 % (males 65% females 35%).

Awmi:
There are totally 357 acute AWMI patients who were subjected to coronary angiogram. Among them 283 ( 79%) were males and 21 percent were females. Among them LAD was recanalized in 46 patients ( normal and minimal CAD) 12% of AWMI patients. SVD of LAD constituted 40% with males comprising 110 (77%) of the 142 people. DVD of LAD and LCX comprise 12% with a predominance of males. DVD of LAD and RCA constitute 56% with a predominant male population. TVD comprise 45 patients ( 13%) with a predominant male ( 78% ) population.

Iwmi :
269 patients with acute IWMI underwent CAG last year. Majority were male making up 76% of the population. SVD of RCA was the most frequent ( 23% ) outcome of the angiogram with males (83% ) forming the majority. TVD make up 20% of the angio report among IWMI cases with males forming 66%. DVD of LAD and RCA form 16% with again a masculine majority. Recanalized vessel was seen in 8% of IWMI patients. SVD of LCX was seen in 7.4% of IWMI patients with again a majority of males (70%). LM with TVD was seen 15 cases ( 5.5%) with again a masculine majority (67%).