CLINICAL PROFILE, ANGIOGRAPHIC CHARACTERISTICS IN WOMEN WITH CORONARY ARTERY DISEASE, ADMITTED IN A TERTIARY CARE HOSPITAL OF EASTERN INDIA

BACKGROUND Women constitute about 48% of the total population in India; however due to inadequate perception and attention, CHD also remains a formidable health problem of women in India and it is rightly said that CHD is under diagnosed, undertreated and under researched disease in women for various reasons. Therefore, this study was designed to determine the clinical profile and angiographic characteristics of women with CAD who presented to our hospital, one of the apex referral centre in eastern part of India. MATERIALS AND METHODS One hundred (100) consecutive in-patients from the department of Cardiology were enrolled in this study during the periodOctober 2015 to October 2017. Ethical committee approval taken from institutional ethics committee. Informed consent from each patient was obtained. Baseline demographics, clinical and risk factor profile were collected. Elective coronary angiography was performed through standard femoral or radial artery approach. Angiographic data were collected by analysing the angiograms by two interventional cardiologists. The Statistical Package for Social Science (SPSS) version 15 was used for data analysis. Categorical data were compared using the chi-square or Fisher’s exact test, as appropriate. RESULTS Maximum incidence of CAD occurred in age group of > 65 years i.e. 32%, compared to 14%, 28%, 26% in 35-44, 45-54, 55- 64 years age group respectively. The most common symptom was chest pain (typical), seen in 100% of patients. The major risk factor in this study was hypertension (50%), diabetes mellitus (34%). We found 60% of patients to be hypercholesterolaemic, 40% were altered triglyceride levels and 40% were having LDL cholesterol of more than 130 mg%. HDL cholesterol of less than 35 mg% was found in 30% of patients. In our study 70% of patients were post-menopausal and only 30% of patients were pre-menopausal with normal cycle. Among post- menopausal women, 30 (42.2%) were diabetic as compared to 8 (26.6%) pre-menopausal women. (P value – 0.126374) Single vessel disease (SVD) was most frequent type of CAD (66%) in young women, whereas it was equally distributed form of CAD in elderly women. (P value – 0.001616). CONCLUSION As per our study the mean age of CAD in female in this part of India is smaller as compared to western studies. Women with CAD, from this part of the country suffer more from angina, sweating, vomiting and palpitation and less from shortness of breath. None of the patient in this study presented with syncope. Dyslipidaemia was the most common risk factor found in this study. Postmenopausal females were suffering more from dyslipidaemia as compared to women with normal cycle. (p value - 0.00011) More than 2/3rd of postmenopausal female were suffering from CAD as compared to pre-menopausal counterpart (1/3rd)