Prevalence, Angiographic Findings and Risk Factors for Premature Coronary Artery Disease in Patients Undergoing Coronary Angiography in Kenyatta National Hospital, Nairobi, Kenya
Résumé
Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality worldwide and poses an emerging challenge in developing countries. While often affecting individuals beyond the sixth decade of life, some populations experience premature CAD (PCAD). However, data on the prevalence, risk factors, and angiographic findings of PCAD in Kenya remains limited. This study aimed to determine the prevalence, angiographic characteristics, and risk factors for PCAD among patients undergoing coronary angiography at Kenyatta National Hospital, Nairobi, Kenya. It was a hospital-based cross-sectional study that included 100 adult patients who underwent invasive coronary angiography. Participants were enrolled consecutively, and data on socio-demographics, risk factors, and angiographic findings were collected from medical records, supplemented with questionnaires when necessary. Angiograms were reviewed with oversight by interventional cardiologists. Data analysis involved descriptive statistics, chi-square/Fisher’s exact tests, and multivariable logistic regression using R software (version 4.1.2). The mean age of participants with premature CAD was 49.8 ± 8.5 years, compared to 69.9 ± 8 years for those with mature CAD. Abnormal angiographic findings were observed in 58 patients, with a premature CAD prevalence of 37.9% (95% CI: 25.8%, 51.7%). Bivariate analysis revealed that females had significantly higher odds of premature CAD compared to males (OR: 3.12, 95% CI: 1.04–9.79, p = 0.045). A significant age difference was noted between males and females with premature CAD (47.2 ± 5.8 vs. 51.9 ± 10 years, p = 0.04). Smoking was significantly associated with premature CAD both before and after adjustment (OR: 0.23, 95% CI: 0.04–0.97, p = 0.045). Hypertension and diabetes mellitus were associated with lower odds of premature CAD compared to mature CAD. Most of the patients had multiple- vessel disease with severe stenosis, but no significant associations were found between risk factors and disease severity. The study concluded that premature coronary artery disease is alarmingly prevalent at Kenyatta National Hospital, with females at higher risk and smoking as a key contributing factor. Most patients in the study had severe obstructive coronary artery disease. These findings emphasize the need for targeted prevention strategies, particularly smoking cessation, to reduce the burden of PCAD in Kenya.
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