Predictors and Prevalence of Obstructive Coronary Artery Disease in Patients Who Underwent Elective Invasive Coronary Angiography for Chronic Coronary Syndrome at Catheterization Laboratory of Tikur Anbessa Specialized Hospital and Gesund Cardiac and Medical Center, Addis Ababa Ethiopia: Retrospective Study

Background: Coronary angiography remains the standard diagnostic test for evaluating the extent of coronary artery disease (CAD). Guidelines for triaging patients for invasive coronary angiography (ICA) recommend risk assessment and non-invasive testing. The yield of ICA in patients undergoing elective ICA in Ethiopia is unknown. Methods: The study involved patients who underwent elective ICA at catheterization laboratory of Cardiology unit of Tikur Anbessa Specialized Hospital and Gesund Cardiac and Medical Center between January 2019 and September 2022 G.C. Data on patient risk profile, Chest pain characteristics and ICA finding were collected from electronic medical record, patient's chart and procedure note with the aid of a structured questionnaire. Obstructive CAD was defined as stenosis of 50% or more of the diameter of the left main coronary artery or stenosis of 70% or more of the diameter of a major epicardial vessel. The data was analyzed using SPSS version 26.0. Results: A total 232 patients, with mean age of 59.9 years, were involved. At catheterization 49.6% were found to have obstructive CAD and 43% of patients had normal epicardial coronary arteries. Hypertension and DM were the commonest comorbidity each occurring in 61% and 53% of the patients. The presence of DM, CKD, and smoking and typical chest pain were independently associated with obstructive CAD. Conclusion: In this study only half of the patients undergoing elective ICA for suspected chronic coronary syndrome (CCS) have obstructive CAD. In consecutive patients undergoing elective ICA for suspected CCS in Ethiopian, obstructive CAD was found in 49.6% of patients despite high prevalence of atherosclerotic risk factors like hypertension and Diabetes mellitus. Diabetes, hypertension, typical chest pain and history of smoking were found to be strong predictors of obstructive CAD.