Varied profile in acute coronary syndrome: One size does not fit all

Abstract

Objective: The objective was to study the clinical profiles of patients undergoing coronary angiography (CAG). Setting and Design: It was a cross-sectional retrospective study of 207 patients who have undergone CAG at B and M Cardiac Centre, Shree Krishna Hospital, from study period of September 2018 to April 2019. Materials and Methods: The patients included were those undergoing CAG of more than 20 years of age. Those who underwent coronary artery bypass graft in the past or re-do CAG and those under 20 years of age were excluded. Data were entered and analyzed with Epi Info version 7. Statistical Analysis: Association between categorical variables was tested with Chi-square test. P <0.05 was considered statistically significant. Observations and Results: Males were higher in the age group of 50–59 years while females predominated in the higher age groups. Hypertension was the most common comorbidity (43.48%) followed by diabetes. Males presented predominantly with anterior and inferior wall myocardial infarction (MI) whereas non-ST-elevation MI, unstable angina, chronic cardiac failure, and atypical presentation were higher in females. Twenty-two percent had normal electrocardiogram whereas a CAG was normal in 22.7% of the patients. Left anterior descending (LAD) involvement was predominant in both males (78.81%) and females (78.57%). Single-vessel disease (SVD) was significantly higher in females (45%). Chest pain (87.4%) and dyspnea (23.2%) were the most common complaints. Smoking was the most significantly associated addiction (P < 0.05). Conclusion: The most common presentation is unstable angina followed by anterior wall MI (AWMI). SVDs are common in females, but when presented with AWMI, triple-vessel disease was found to be most commonly associated with AWMI in females than males. As age progresses, the number of vessels involved increases. Echo is best correlated with anterior and inferior wall MI. LAD is the most common culprit vessel in both males and females. Multiple vessel involvement was common in diabetics. SVD was most common in hypertensives.