Coronary artery disease and its predictors in a tertiary hospital, Bangladesh

Abstract

Background: Coronary artery disease (CAD) poses a massive challenge globally. CAD is also a major health problem and the most common cause of premature morbidity and mortality in Bangladesh. In the global combat against CAD, Bangladesh is a country missing in action. Objective: To determine the status of coronary artery disease and its predictors of the patients performed successfully coronary angiogram (CAG) in the Cardiac Unit, Rajshahi Medical College Hospital, Bangladesh. Methods: This was a descriptive cross-sectional study conducted at Cardiac Unit of Rajshahi Medical College Hospital, Bangladesh. Total 400 patients, who successfully completed CAG in Cath Lab of Rajshahi Medical College, were selected in this study. Data were collected by pretested structured Patient Record (PR) Card by interview of the patients and from their respective coronary angiogram (CAG) reports in their treatment files. This PR card was designed to record patient's socio-demographic status, life style, history of systemic diseases and the angiographic findings. Chi-square test was applied to find out the association between the coronary artery disease, and the socio-demographic characteristics, life style and history of systemic disease of the patients. Multiple logistic regression was applied to identify the predictors of CAD. Results: Out of 400 study subjects, 275 (69%) patients had coronary artery disease. Of the total 275 patients who had CAD, more than 80% had single artery disease. Hypertension (odds ratio (OR): 8.11(95% CI 3.57-18.38)), tobacco consumption (OR: 3.36 (95% CI 1.85-6.09)), diabetes mellitus (OR: 3.10 (95% CI 1.61-5.97)) and higher monthly family income (OR: 2.82 (95% CI 1.55-5.11)) were identified as important predictors of CAD. Conclusion: Clinicians should consider hypertension, diabetes Melitus and tobacco consumption to predict the risk of CAD during patient selection for angiogram for improvement of precision. Existing health education program regarding screening and treatment of high blood pressure and diabetes mellitus, and avoidance to tobacco consumption should be promoted for the prevention and control of CAD at the individual and community level.