impact of age and sex in the pattern of coronary artery disease

ABSTRACT

Coronary Artery Disease [CAD] is the primary cause of death in the world. Over the last three decades, invasive procedures such as coronary artery bypass grafting [CABG] and percutaneous coronary interventions [PCI] have resulted in significant improvements in survival and quality of life for patients. Besides traditional modifiable risk factors, it has been proved that some fixed, nonmodifiable factors contribute in the behaviour of coronary involvement. To see whether the age and sex as a coronary risk factor contribute this differential coronary involvement, we conducted this study. To determine the frequency of coronary artery disease [CAD] as it varies with age and gender. It is a descriptive study carried out at NICVD Karachi. All the subjects were adults with previous history of ischemic heart disease and recommended coronary angiography based on history and non-invasive tests. There were 79.6% male patients and the mean age was 52 years [ranged from 28 to 85 year]. In 80% of patient femoral artery access was used for performing the procedure. Right coronary artery was found dominant in 73% angiograms. Left anterior descending artery was the most frequently involved artery[73.6%] among major coronary arteries and obtuse marginal was most frequently involved [20.4%] branche artery. Ramus intermedius was found diseased in 4.2%.The frequency of involvement of Left Main artery and distal segments of major coronary arteries was increased with advancing age but there was no significant association between age and sex and involvement of other coronary arteries. In conclusion males have a higher recorded rate of coronary angiography and single vessel disease is the most common finding. Females and ages above 80 and below 40 had low incidence of angiographic events