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Coronary arteriographic profile in young and old Indian patients with ischaemic heart disease: a comparative study
1Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi.
Insights
Young Indian patients with ischemic heart disease (IHD) show extensive coronary artery involvement, similar to older patients. Left main and LAD artery disease, along with calcification, are more prevalent in older individuals.
Area of Science:
- Cardiology
- Vascular Medicine
- Public Health
Background:
- Ischemic heart disease (IHD) typically affects older populations.
- Understanding coronary artery profiles in young IHD patients is crucial for early diagnosis and treatment.
- Indian populations may present unique patterns of cardiovascular disease.
Purpose of the Study:
- To compare the coronary arteriographic profiles of young (<40 years) and older (≥40 years) patients with IHD.
- To identify differences in vessel involvement, disease extent, and specific coronary artery lesions between the two age groups.
- To characterize the pattern of coronary artery disease in young Indian patients with IHD.
Main Methods:
- Retrospective analysis of coronary arteriograms from 125 young IHD patients (Group I) and 125 older IHD patients (Group II).
- Comparison of the incidence of left anterior descending (LAD) and left main coronary artery involvement.
- Assessment of coronary artery calcification, triple vessel disease, diffuse disease, ectasia, and coronary collaterals.
Main Results:
- Left anterior descending coronary artery involvement was high in both groups (81.6% in young, 96% in older).
- Left main coronary artery disease (4% vs 12%) and coronary calcification (13.7% vs 57.6%) were significantly more common in older patients.
- Triple vessel disease was the most common form in both groups (44.8% vs 52.8%), with no significant difference.
Conclusions:
- Older IHD patients exhibit a higher incidence of left main coronary artery disease and coronary calcification.
- Young Indian patients with IHD frequently present with multivessel and extensive coronary artery involvement.
- The pattern of coronary artery disease in young Indian patients shares similarities with that of their older counterparts, suggesting a need for early risk factor management.
Abstract:
We analysed coronary arteriographic profile in 125 young patients (below 40 years, mean age 37.3 years) with clinical evidence of ischaemic heart disease (IHD) (Group I) and compared it with 125 older patients with IHD (more than 40 years, mean age 52.8 years) (Group II) studied during the same period. Left anterior descending coronary artery was the most frequently involved vessel in both the groups, 102/125 (81.6%) in Group I and 120/125 (96%) in Group II (P less than 0.001). The incidence of left main coronary artery involvement was 5/125 (4%) in Group I and 15/125 (12%) in Group II (P less than 0.05) and coronary artery calcification was 17/125 (13.7%) in Group I and 72/125 (57.6%) in Group II (P less than 0.001). Triple vessel disease was the most common form of involvement, 56/125 (44.8%) in Group I and 65/125 (52.8%) in Group II (P = NS). The incidence of diffuse disease was 35/125 (28%) in Group I vs 39/125 (31.2%) in Group II (P = NS), ectasia was observed in 13/125 (10.1%) in Group I vs 15/125 (12%) in Group II (P = NS) and coronary collaterals were found in 42/125 (33.6%) in Group I and 56/125 (44.8%) in Group II (P = NS). Thus left main and left anterior descending coronary artery disease and coronary calcification were more common in the older age group. Our findings suggest that in young Indian patients with IHD, multivessel and extensive coronary artery involvement in frequently seen. This pattern of involvement has many features resembling the disease pattern in their older counterparts.