Aamir Javaid, Ghulam Mustafa, Liaqat Ali, Hamid Khalil, Muhammad Khalid Razaq, Shama Iqbal.
Audit of coronary artery disease in patients who underwent coronary angiography at a tertiary care hospital and frequency of right system dominance.
J Cardiovascular Dis Jan ;16(3):94-7.

BACKGROUND: Ischemic heart disease or Coronary artery disease (CAD) is a problematic epidemic in our country leading to premature disability in the form of heart failure, loss of job, loss of interest in life and dependency either by myocardial infarction or unstable angina which causes ischemic cardiomyopathy. This study was conducted to determine coronary angiographic findings among patients undergoing coronary angiography in our catheterization laboratory (Cath Lab) and to determine the right system dominance. MATERIAL AND METHODS: Cross sectional, retrospective study was carried out at Cardiology department of Shaikh Zayed Medical College/Hospital Rahimyar Khan from February 2011 to December 2017. A total of 1719 patients who has undergone coronary angiography were included for study analysis. All the patients undergoing coronary angiography regardless of age and gender were included. Congestive heart failure patients, patients of chronic liver disease, patients having impaired renal functions, fever, septicemia, prior stroke or disability or not giving consent for coronary angiography were excluded. Variable selected were coronary angiographic findings (like coronary dominance, disease of left main coronary artery (LMD), left anterior descending coronary artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) and risk factors like smoking, hypertension (HTN),diabetes mellitus (DM), dyslipidemia and family history (FH). RESULTS: The patients were having a mean age of 51+-10 years. 1274 (74%) were male, 1027 (57.2%) were from rural areas. 1282 (70.5%) were having right coronary system dominant, 383 (22%) were diabetics, 643 (37%) were hypertensive, only 46 (2.7%) were having family history of Coronary heart disease. Out of 1719 patients who has undergone angiography, 932 were advised Echocardiography, among these 563 (60.4%) patients were having normal left ventricular ejection fraction (LVEF). 1537 patient's record for angiographic findings was sufficient and included for analysis. 626 (40.7%) were having triple vessel disease, 307 (19.9%) were having double vessel diseases and 302 (19.6%) were having single vessel disease. CONCLUSION: This study concludes that in our patients who underwent angiography, most common vessel dominance system was right. Hypertension, diabetes mellitus, and family history of CAD were common risk factors. Majority of the patients who has under gone angiography, were having normal LVEF. Most common coronary disease pattern was involvement of all three vessels followed by double vessel diseases and single vessel disease.

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