A Comparison Of Clinical Profiles Of Patients With Normal And Abnormal Coronary Arteries: A One-Year Case Control Study In Kles Hospital Population

Abstract

Background and Objectives Cardiovascular diseases are on the rise in India. According to the WHO report in 2012, 17.5 million deaths occurred due to CVDs. Nearly 75 % of mortality was encountered in developing countries. There are many hazards for coronary mishaps. Case-control studies have described that key risk factors for CHD in India are dyslipidemias, smoking, diabetes, hypertension, truncal obesity, stress, diet, and a sedentary lifestyle To date, no single risk factor has been identified to be responsible for causing CVD. Rather, multiple interrelated factors seem responsible for its development. Our study aimed to study the prevalence of abnormal coronary arteries among the adult patients and further assess their clinical, metabolic profile and risk factors and its association to that of controls. Methodology A group of 602 consecutive patients whose coronary angiography was done were studied. Clinical examination with body mass parameters noted. Hemoglobin (Hb), serum creatinine, Lipid profiles with cholesterol, LDL, HDL, Triglycerides, Glycosylated hemoglobin (Hba1c) and random blood sugar (RBS) of all the patients was noted. A detailed analysis was done to compare the differences between normal and abnormal coronary angiographies. Results The study population comprised of 602 subjects with a mean age of 58.16 ± 12.41, ranging between 19 years to 92 years. Males were more at risk for coronary artery disease as per our study population. Hip circumference and waist-hip ratio were statistically significant, and increased waist-hip ratio was a risk factor for CAD. We found that lifestyle, exercise, vegetarian diet were not significantly protective against the development of coronary artery disease as per our study. Smoking and alcohol consumption were not found to be significant risk factors for CAD as per our study. However we observed that tobacco chewing was found to be a significant risk factor for the development of CAD in our study. Presence of comorbid metabolic conditions like Hypertension and Diabetes Mellitus were both noted to be significant risk factors for coronary artery disease in our study. Random blood sugar, glycosylated hemoglobin, serum creatinine and hemoglobin were found to be significantly abnormal in the group with abnormal CAG indicating these parameters as individual risk factors for CAD (P Value <0.001). However, the difference in the LDL, HDL, Triglycerides and cholesterol was statistically not significant in our study. (P Value 0.752, 0.535, 0.837. 0.193). We noted that univariate logistic regression analysis showed a statistically significant association with coronary angiography with age, gender, creatinine, HBA1c, RBS. Conclusion We concluded that increased waist-hip ratio, tobacco chewing and comorbidities like hypertension and diabetes mellitus were risk factors for Coronary artery disease (CAD). Random blood sugar (RBS), Glycosylated hemoglobin (HbA1c), Serum creatinine and Hemoglobin were found to be significantly abnormal in diseased coronary angiographies indicating these parameters as individual risk factors for CAD. However, lipids did not have any bearing on CAD as per our study.