Incidence of coronary artery anomalies among patients undergoing coronary angiography and its relevance to appropriate choice of coronary catheter selection

摘要

Background: The incidence of acute coronary syndrome (ACS)among younger age group without conventional risk factors isincreasing. Demographic, clinical and angiographic data regardingthe extent and severity of coronary artery disease (CAD) in youngIndian patients with manifest ACS is very limited.Objective: Aim of our study was to study the demographic, clinicaland coronary angiographic profile in young Indian myocardialinfarction (MI) patients (<45 years) among non smokers and nondiabetics.Methods:Atotal of 100 cases were enrolled in our study. Variousdemographic (age, sex, mode of transport, time to reach the studycenter), clinical (presence of congestive heart failure, hypotension)and angiographic variables were studied.Results: Of the 100 cases studied, mean age is 35.84±6.57years. 25% (n = 25) were females and 21% had hypertension. 68% ofcases used own transport to reach the hospital and the mean timetaken to reach the emergency department aftersymptomonsetwas9.54±3.20 h. Most common reason for delay in reaching the studycenter was “not being aware of urgency of the procedure despiteknowing the treatment.” 49% cases presented with ST segmentelevation anterior wall myocardial infarction. 10% had congestiveheart failure and 7% had hypotension at presentation. 61% casesunderwent percutaneous coronary intervention (PCI), 19% of caseswere thrombolyzed and the rest were managed conservatively.Mean left ventricular ejection fraction (LVEF) was 36.96±5.88%. Oncoronary angiogram, left anterior descending artery (LAD) was thecommonest artery to be involved. 7% had double vessel disease, 5%had triple vessel disease and 2% cases had left main coronary artery(LMCA) involvement.Conclusion: This study gives interesting insights into demographic,clinical and angiographic variables in young Indian MIpatients, who have not been studied previously.