Key result
Angiography shows significant CAD in ~69% of chest pain patients, primarily involving the LAD.
Why the study?
Coronary angiography findings in patients presenting with chest pain with or without electrocardiogram abnormalities in Afghanistan were not well described.
Observational (n=372)
No
Answers are grounded in this paper and cite their sources.
In an Afghan cohort presenting with chest pain, the left anterior descending artery was the most commonly involved vessel, and the prevalence of triple vessel disease increased significantly with age.
Aim: Coronary artery disease is the leading cause of mortality and morbidity globally. Its diagnosis starts with workup of routine examinations and is confirmed by coronary angiography. The main purpose of the study was to find out angiographic findings in patients presenting with chest pain with or without electrocardiogram abnormalities. Methods: It was a retrospective descriptive single setting hospital based study conducted at Afghan Momand Medical complex, a tertiary care center in Nangarhar, Afghanistan. The study included 372 patients with chest pain with or without electrocardiogram abnormalities. Results: Mean age of the study population was 56.6 ± 11.7 years. 50 (13.4%) patients with chest pain had normal coronary angiography (CAG) while 64 (17.2%) patient had non critical CAG and the rest had significant disease on CAG described as64 (17.2%) patients had single vessel disease (SVD) while 40 (10.8%)had double vessel disease (DVD) and the rest 82 (22%) had triple vessel disease (TVD). Left anterior descending coronary artery was the leading involved artery (206, 45%) followed by right coronary artery (133, 29%) and left circumflex (119, 26%) respectively. Incidences of TVD increased with increasing age as it was not involved in the lowest two age groups (0. 0%) while it was in involved in 24 (29.3%), 33 (40.2%), and 15 (18.3%) in the age groups 50-59, 60-69, and 70 through highest age groups respectively. Conclusion: We concluded that coronary angiography precisely prescribed is a gold standard investigation to find out ischemic heart disease in patients with chest pain and/or electrocardiogram abnormalities. In fact, left anterior descending coronary artery was the most leading diseased artery in the forms of both single vessel disease and multiple vessel disease. Moreover, prevalence of triple vessel disease significantly increased with increasing age. Angioplasty was a matter of concern which needs to be evaluated with further researches about why some patients with single vessel disease did not undergo subsequent angioplasty and some with triple vessel disease underwent angioplasty.
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Shams et al. (2023) conducted an observational in Chest pain with or without electrocardiogram abnormalities (n=372). Chest pain with or without ECG abnormalities was evaluated on Significant coronary artery disease on coronary angiography. Among 372 patients presenting with chest pain, 69.4% had significant coronary artery disease on angiography, with the left anterior descending artery being the most commonly involved (45%).
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