The prevalence of risk factors and pattern of obstructive coronary artery disease in young indians (< 45 years) undergoing percutaneous coronary intervention: a gender-based multi-center study

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background In a retrospective study, we aimed to explore the prevalence of risk factors and trends of obstructive coronary artery disease (CAD) in Indian females under 45 years old compared to males of the same age group who underwent percutaneous coronary intervention (PCI). Purpose With changing lifestyles, the onset of traditional risk factors at the early stages of life is the major culprit for developing CAD at an early age. For several years, the significance of CAD in young women was underestimated. There are some sex-related variations in CAD, and symptoms of CAD in women, regardless of age, have low specificity even in the absence of risk factors. Materials and Methods This was a retrospective, observational, multi-centre study of young Indian females and males (< 45 years) who underwent PCI as per the guidelines at three high-volume centres of India. The study evaluated the prevalence of risk factors, clinical and angiographic patterns of obstructive CAD in young Indian women compared to men. Results In a cohort of 3656 patients who underwent PCIs, 113 young females comprised 3.1% of those with obstructive CAD, while 254 young males constituted 6.9%. Traditional risk factors such as hypertension, diabetes, and family history of premature CAD were the most common in both genders, whereas dyslipidaemia, obesity, smoking, and alcoholism were more common in young males. The acute coronary syndrome was the most common clinical presentation. The single-vessel disease was common with the involvement of the left anterior descending artery as a most common angiographic feature. The prevalence of cardiogenic shock was 4.4% in females and 4.1% in males while the in-hospital mortality rate was 1.77% in young females and 2% in young males. Conclusion CAD in young Indians is on the rise, and frequent screening for obstructive CAD should be done, especially in those with symptoms and risk factors.