Changing Trends of Angiographic Profiles in Women with Coronary Artery Disease over a Decade

Abstract

Background Cardiovascular diseases, especially coronary artery disease (CAD), have assumed epidemic proportions worldwide. CAD is the leading cause of disability and death in women. In woman during postmenopausal years, traditional risk factors tend to become very present and increase the risk for CAD. Patterns in epidemiology of CAD are doubtlessly changing continually in many ways, only some of which are recognized at any given point of time. Aim To identify the changing trends of CAD in female patients who were admitted for coronary angiogram (CAG) over a period of 10 years. Materials and Methods We retrospectively collected the data of female patients from our unit CAG registry. We noted the demographic data (age, ethnicity, socioeconomic status), clinical data (diabetic status, hypertension status, symptoms and their duration, past history), laboratory data (complete blood picture, cardiac enzymes, renal function tests, liver function tests, serum electrolytes), and CAG findings (normal coronaries [NC]/single-vessel disease [SCD]/double-vessel disease [DVD]/triple-vessel disease [TVD]) of the female patients in 2007 and a decade later that was 2017. Results Data of 64 women in 2007 and of 184 in 2017 were analyzed. CAG women in 2017 were older than those in 2007 (53.1 ± 11.7 vs. 57.1 ± 12.3 years; p = 0.024). There was no significant difference found in the parameters such as hypertension (p = 0.797), diabetes mellitus (DM) (37.5% vs. 41.3%; p = 0.59), left ventricular (LV) dysfunction, type of presentation (acute coronary syndrome [ACS] or chronic stable angina [CSA]) and presence of CAD (53.9% vs. 51.1%; p = 0.69). In the 2017 female group, there was increase in detection of the electrographic (ECG) abnormalities (98.4% vs. 62.5%; p = 0.000). Radial route was used more frequently for CAG (98.4% vs. 40.6%; p = 0.000). Subgroup analysis of CAD (proven angiographically) showed a statistically significant difference of occurrence of SVD that was more frequent in 2007 female group (32.8% vs. 20.1%; p = 0.05), whereas TVD (was more frequent in 2017 female group (14.1% vs. 4.6%; p = 0.01). Conclusion This study shows that even though there was no change in the incidence of occurrence of normal coronaries on angiogram over time; however, there was a significant increase in severity of the CAD (TVD) in 2017 female group (p = 0.01).