Prevalence, Angiographic Findings and Risk Factors for Premature Coronary Artery Disease in Patients Undergoing Coronary Angiography in Kenyatta National Hospital, Nairobi, Kenya

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Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality worldwide and poses an emerging challenge in developing countries. While often affecting individuals beyond the sixth decade of life, some populations experience premature CAD (PCAD). However, data on the prevalence, risk factors, and angiographic findings of PCAD in Kenya remains limited. This study aimed to determine the prevalence, angiographic characteristics, and risk factors for PCAD among patients undergoing coronary angiography at Kenyatta National Hospital, Nairobi, Kenya. It was a hospital-based cross-sectional study that included 100 adult patients who underwent invasive coronary angiography. Participants were enrolled consecutively, and data on socio-demographics, risk factors, and angiographic findings were collected from medical records, and supplemented with questionnaires when necessary. Angiograms were reviewed with oversight by interventional cardiologists. Data analysis involved descriptive statistics, chi-square/Fisher’s exact tests, and multivariable logistic regression using R software (version 4.1.2). Participants had a mean age of 62.3 years (±12.8), with males comprising 60% of the sample. Abnormal angiographic findings were observed in 58% of participants. Among these, the prevalence of PCAD was 37.9% (95% CI: 25.8%-51. 7%). Smoking emerged as a significant risk factor for PCAD (adjusted OR: 0.23, 95% CI: 0.04-0.97, p = 0.045). Conversely, hypertension and diabetes mellitus were associated with reduced odds of PCAD compared to mature CAD. No significant associations were found between risk factor profiles and the number of vessels involved or stenosis severity. Most patients exhibited multi-vessel disease with significant stenosis. In conclusion, the prevalence of PCAD in this cohort was high. Smoking was the only independent risk factor, while hypertension and diabetes showed inverse associations. Further research should focus on addressing modifiable risk factors, particularly smoking, to reduce the burden of PCAD.