Statistical analysisĭata analysis was performed by using Microsoft Office Excel 2007and SPSS for Windows, version 16.0. Complexity of lesions was further categorized according to the joint American College of Cardiology/American Heart Association (ACC/AHA) classification system into: Type A, B and C lesions. Stenosis of the coronary vessels was considered mild when the luminal diameter was reduced by (70 % of the original diameter. The patients were grouped according the number of major epicardial coronary arteries into one vessel disease (1VD), two vessels disease (2VD), three vessels disease (3VD) or four vessels disease including left main stem (LMS) (4VD). Both eye-balling method and quantitative coronary angiography (QCA) were used to estimate the percentage, morphology and length of the coronary lesions. A detailed analysis of angiographic images was done by the operators. Coronary angiographyĭiagnostic CAG was performed by a team of expert interventional cardiologists. Diagnoses of these clinical presentations and cardiovascular risk factors were based on international standard definitions. Patients were checked for obesity, diabetes mellitus, hypertension, smoking, and family history of coronary artery disease. Patients were divided into PCAD and MCAD group and the premature group was subdivided into males and females for comparison.įull size image Clinical presentations and cardiovascular risk factorsĬlinical presentations of patient were classified into chronic stable angina, prior acute coronary syndromes including unstable angina (UA), NSTEMI, and STEMI. CAD manifested in male <45 years and in female < 55 years old was defined a PCAD. From the recruited sample, 97 cases had normal angiograms and other 45 had prior coronary revascularization (PCI or CABG) and both were excluded from the study (see Fig. A total of 303 cases (178 men and 125 women) with a mean age 53.8 (SD 5.8) were met these criteria and provided written informed consent. Inclusion criteria included all patients aged ≥18 years, presented with CAD/acute coronary syndrome (ACS), and underwent CAG based on the ACC/ESC indications for CAG for the first time whose coronary angiograms revealed documented coronary lesions. We examined in this cross sectional study a total of 445 clinically diagnosed CAD patients who underwent coronary angiography (CAG) at Duhok Heart Center, Kurdistan, Iraq in the period between March and September 2014. This study was aimed at examining the prevalence, clinical presentations, associated cardiovascular risk factors, coronary angiographic profile, and therapeutic options in the PCAD compared to MCAD. Studies on PCAD in certain countries may vary relevant to the populations studied, and the data on PCAD available in Iraq is scarce. Patients with PCAD belong to a particular subgroup that needs much more attention since its impact on individuals, families and the society is devastating. Clinical studies have affirmed that patients with PCAD have a different clinical presentation, associated CAD risk factors, and coronary angiographic profile compared with the MCAD. The PCAD is defined, in various studies, as having an age of onset ranging from 30 to 56 years. It is estimated that about 4–10 % of individuals with documented CAD are less than 45 years. Nowadays, however, it’s often encountered by young adults. CAD is a disease usually found in the old. But the angiographic profile and therapeutic options of PCAD are close to those reported from previous studies.Ĭoronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Cardiovascular risk factors are clustered among them. Premature coronary artery disease is alarming in the country. Patients were divided into PCAD (male 70 % compared to lesser obstruction. Methodsĭata was collected from a total of 445 adult patients undergoing coronary angiography at Duhok Heart Center, Kurdistan in a period between March and September 2014. Given the lack of such studies in the country, this study examines the prevalence, associated cardiovascular risk factors, and coronary angiographic profile of the disease in Iraq. Premature coronary artery disease (PCAD) seems to increase, particularly in developing countries.
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