Clinical Characteristics and Outcomes of Coronary Artery Disease among South Indian Women- A Retrospective Study

Introduction: The prevalence of Coronary Artery Disease (CAD) is increasing among Indian women and is the leading cause of death. Clinical presentation of CAD in women can widely vary from atypical chest pain, silent ischemia to massive myocardial infarction and death. Women have poor prognosis than men after myocardial infarction and are less likely to undergo revascularisation compared to men. Aim: To study the risk factors, clinical characteristics, severity of CAD and to evaluate the outcomes in women undergoing coronary angiogram. Materials and Methods: This retrospective study included 912 women who had undergone coronary angiogram in our hospital from January 2018 to December 2018. The patients were divided into three groups- Group A consisted of 230 (25%) women with age <50 years. Group B consisted of 591 (65%) women with age between 50 to 69 years. Group C consisted of 91 (10%) women with age >70 years. Continuous variables were analysed by paired t-test and categorical variables were analysed by chi-square test. Results: Most women were post menopausal (73.6%). Common risk factors were diabetes mellitus (63%) hypertension (56%), and hypothyroidism (16.8%). Out of the total study population, 51% (n=466) presented with a diagnosis of chronic stable angina, 34.7% (n=317) presented with acute coronary syndrome, and 7% (n=66) had atypical chest pain. Out of 500 patients with significant CAD, requiring revascularisation only 316 (63.2%) had undergone interventions out of which 193 (61%) had undergone percutaneous coronary intervention and 123 (39%) had undergone Coronary Artery Bypass Grafting (CABG) as the modality of revascularisation. Conclusion: Clinical presentation of CAD in women varies widely from atypical chest pain to acute infarction. Diabetes and hypertension are the most common risk factors for CAD in our study. Chronic stable angina was the most common spectrum of presentation. Single vessel disease is the most common finding on coronary angiogram