Pattern of coronary artery diseases in relation to various risk factors in Egyptian women in Upper Egypt

Abstract

Background Coronary artery disease (CAD) constitutes one of the leading causes of death in women. Awareness of CAD as the primary cause of mortality in women has been slowly increasing. Coronary angiography (CA) is a useful tool for diagnosis and treatment of CAD. Sex differences play an important role in the pathophysiology of CAD that may contribute to different outcome. Aim To assess the pattern of CAD in women in Upper Egypt undergoing CA. Patients and methods A total of 100 women living in Upper Egypt who experienced chest pain and were indicated for coronary angiography were enrolled in the study. They were classified into two groups according to their age: group 1, with age less than 55 years old (45 patients) and group 2, with age more than 55 years old (55 patients). Interpretation of coronary angiography included detailed assessment of the presence, distribution, and severity of coronary lesions. Severe CAD was considered in patients with left main (LM) disease, patients with multivessel disease, and patients with bifurcation lesions. Result The study revealed normal coronary angiography in 20%, nonsignificant lesions in 13%, and obstructive CAD in 67% of our study population. There was significantly higher incidence of normal coronaries among patients in group 1 compared with patients in group 2 (P=0.012) and significantly higher obstructive lesions and severe CAD in patients in group 2 compared with patients in group 1 (P=0.002 and 0.011, respectively). Multivariate regression analysis for the presence of severe CAD revealed that diabetes mellitus and positive family history of premature CAD were highly significant independent predictors (P<0.001), whereas both age more than or equal to 55 years and dyslipidemia were significant independent predictors (P=0.003 and 0.002, respectively). Conclusion The incidence of CAD is high among women undergoing coronary angiography in Upper Egypt. Normal vessels, single-vessel disease, and simple lesions tend to be more in younger women, whereas severe and complicated lesions are more in elderly women.