ANGIOGRAPHIC PROFILE IN WOMEN WITH CORONARY ARTERY DISEASE

BACKGROUND Coronary artery disease is the leading cause of morbidity and mortality among women as well as men in the industrialised world. Women represent 60 percent of those over the age of 65 years in the United States and more women than men have died of cardiovascular disease. Women and men with Acute Coronary Syndromes (ACS) have been found to have different clinical profiles and presentation with a smaller percentage of women than men presenting with ST-elevation MI, but more presenting with unstable angina. Women are more likely to die of first myocardial infarction, experience more long-term disability and have more comorbidities as presentations is later in life. Women also are less likely to undergo angioplasty or bypass surgery. Fewer women receive cardiac rehabilitation and medications. Hence the purpose of the study was to analyse the angiographile profile in relation to clinical presentation and risk factors. Aims and Objectives- To analyse the angiographic findings in relation to clinical presentation and risk factors. MATERIALS AND METHODS Female patients with STEMI, NSTEMI or chronic stable angina without significant comorbidities were studied after Institutional Committee approval and informed consent from subjects and results were analysed. RESULTS Of the 140 patients studied, 85% belonged to post-menopausal age and the mean age of patients was 54.19 +/- 9.89 years. 68% had angiographic evidence of coronary artery disease, of which 48% had significant coronary artery disease. LAD (41%) was the commonest vessel and single vessel disease (39%) predominated among significant CAD cases. The relationship between diabetes (p= 0.009), BMI >/= 25 (p= 0.007), family history of premature CAD (p= 0.006), total cholesterol >/= 200 (p= 0.011), LDL >/= 100 (p= 0.006) and HDL </= 40 (p= 0.009) were found to be statistically significant in the study. CONCLUSION The incidence of coronary artery disease is high in postmenopausal women as compared to premenopausal women. Women with acute coronary syndromes present more with unstable angina/ NSTEMI. Women are less likely to present with the syndrome associated with occlusive thrombus, that is with infarction with ST elevation.