Coexistent Coronary Artery Disease in Patients Undergoing Permanent Pacemaker Implantation - A Study from Major Center in North Eastern India

Abstract

ABSTRACT Aim: Data regarding the incidence of coexisting coronary artery disease (CAD) in patients undergoing permanent pacemaker implantation (PPI) in our country are limited. The incidence of coexisting CAD and its clinical characteristic in patients undergoing PPI have not been reported from North-east India. This study has been undertaken to study the incidence of coexisting CAD in patients undergoing PPI with risk factors for CAD or with documented atherosclerotic cardiovascular disease (ASCVD) and also to compare the clinical characteristics between patients with and without CAD. Materials and Methods: We prospectively collected data of patients undergoing PPI in our center from June 2020 to December 2021. We evaluated data on indications and clinical characteristics of patients undergoing PPI having risk factors for CAD or with documented ASCVD and also compared the clinical characteristics between patients with and without CAD in the study population. Results: A total of 289 subjects underwent PPI during the study period, of which 54 patients were included in the study, who had risk factors for CAD or with documented ASCVD. The mean age of the patients was 62.93 ± 9.06 years. Males outnumbered females with a male-to-female ratio of 5.7:1. CAD was observed in 63% of the study population and 29.6% had obstructive CAD. Patients with CAD were predominantly males (94.1% vs. 69.7%, P = 0.01) and had a statistically significant increase in the incidence of dyslipidemia (79.4% vs. 50%, P = 0.026) and left ventricular (LV) systolic dysfunction (26.5% vs. 5%, P = 0.0544). The incidence of hypertension (70.6% vs. 45%), diabetes (61.8% vs. 35%), smoking (61.8% vs. 55%), and mean age (64.41% vs. 60.4) was also higher in the CAD group though not statistically significant. Conclusion: The present study represents the first reported study on the incidence of coexisting CAD in patients undergoing PPI with risk factors for CAD or with documented ASCVD from Northeast India and has observed the incidence to be 63%, of which 29.7% had obstructive disease. Patients undergoing PPI with coexisting CAD were predominantly males and had a statistically significant increase in the incidence of dyslipidemia and LV systolic dysfunction. There was also increase in the incidence of hypertension, diabetes, and smoking in the CAD group though statistically not significant.