Abstract

Background: The traditional risk factors of coronary artery disease (CAD) are Age, Genetic factors, Smoking, Hypertension, Diabetes and Dyslipidemia occurrence of each of which influence the presentations of the disease and its severity of the angiographic profile. With changing scenario of risk factor assessment due to global increase in CAD and starting the statins quite early for patients with risk factors without the CAD, we want to see the present status of lipids in patients undergoing coronary angiogram (CAG).

Objective: We aim to evaluate the occurrence of various risk factors especially lipid abnormalities and correlate them with angiographic severity in patients presenting with CAD and undergoing CAG

Methods: We evaluated 504 consecutive patients already on statins presenting with CAD and undergoing coronary angiogram between august 2015 to December 2016 at our center. We obtained the detailed clinical, biochemical and angiographic profile from the records and analyzed the occurrence of risk factors and correlated the lipid abnormalities and angiographic profile for any statistical significance using Minitab 17 software.

Results: Of the total 504 patients 331 (65.6%) were males. 347 (68.8%) had Hypertension, 258 (51.1%) had DM, 370 (73.4%) had Dyslipidemia and 128 (25.3%) had LV dysfunction. 303 (60.1%) had abnormal coronary angiograms. Of these 148 (48.8%) had single vessel disease (SVD), 85 (28%) had double vessel disease (DVD), 70 (23.2%) had triple vessel disease (TVD). Abnormal CAG is significantly found in Males (p = 0.03), Hypertension (p = 0.00), DM (P = 0.01) and LV dysfunction (p = 0.00). Dyslipidemia had tendency for correlation with abnormal CAG but not statistically significant (p = 0.07). The levels of LDL, HDL and triglycerides didn't correlate with the angiographic abnormality. In patients with severe CAD i.e. TVD the determinants are age (p = 0.01), male sex ( p = 0.01), smoking (p = 0.02), HTN (p = 0.002), DM (p = 0.03), LV dysfunction (p = 0.006). Neither Dyslipidemia (p = 0.2) nor levels of Total cholesterol, HDL, LDL, TG determined the occurrence of TVD. Occurrence of DVD correlated significantly with age (p = 0.001), male gender (p = 0.002) and LV dysfunction (p = 0.02). In SVD Male gender (p = 0.003), HTN (p = 0.001), LV dysfunction (p = 0.00), TG (p = 0.03) had showed significant correlation. Occurrence of Dyslipidemia didn't show any correlation with the occurrence of SVD (p = 0.26) or DVD (p = 0.43). High levels of individual lipid components except TG in SVD didn't show any correlation in occurrence of DVD or SVD.

Conclusion: In patients presenting with CAD on statins with abnormal CAG, age, male gender, HTN, DM and LV dysfunction of any severity are the determinants but not the occurrence of Dyslipidemia or the levels of Total cholesterol of LDL, HDL or TG. The occurrence of Dyslipidemia or levels of individual lipid component abnormalities except for high levels of TG in SVD didn't show any significant correlation with the occurrence of SVD, DVD or TVD.