Characteristics, prevalence, pattern and risk factors of coronary artery disease among patients undergoing coronary angiogram at Jakaya Kikwete Cardiac Institute January 2015 – June 2017

Abstract

ABSTRACT Background: Coronary artery disease (CAD) remains a significant cause of morbidity and mortality worldwide. Little is known about CAD in Tanzania and many other countries of sub Saharan Africa. This study aimed to shed light on the burden, pattern, and associated risk factors among patients undergoing CAG in a Tanzanian population. Objective: To describe the characteristics, pattern, and determine the associated risk factors for CAD among patients undergoing coronary angiogram at Jakaya Kikwete cardiac institute (JKCI) between January 2015 and June 2017. Methods: A cross-sectional analysis of the JKCI catheterization–laboratory (cath-lab) database between January 2015 and June 2017 was conducted. All patients with complete key data were included. Linear logistic regression analyses were performed to determine associated factors for CAD. All analyses were 2-sided and p value < 0.05 was used to denote significance. Variables of interest included, age, sex, co morbidities, renal functions, information regarding smoking status, electrolytes, full blood count, serology for HIV, Hepatitis B & C and syphilis, diabetes, weight and height (for BMI calculation), hypertension and cholesterol. Results: The mean age was 60.6 years and over 83% of participants were aged 50 years and above. Males comprised 60% of all participants and over two-thirds of participants were overweight or obese. Hypertensive heart disease (43%) was the commonest underlying aetiology followed by Ischemic heart disease (35%). The prevalence of coronary artery disease (CAD) was 45.5%. Among patients with CAD, single vessel involvement was more common (43.6%) and LAD was the most involved vessel (78%). During multivariate analyses, Male sex (OR 2.6, 95% CI 1.6-4.1, p<0.001), BMI ≥ 25 (OR 2.2, 95% CI 1.3-3.8, p<0.01), and Diabetes Mellitus (OR 3.2, 95% CI 2.0-5.2, p<0.001) were found to be independent predictors of CAD. Conclusion: Coronary artery disease is considerably prevalent among patients undergoing coronary angiogram at Jakaya Kikwete Cardiac Institute, LAD being the most affected vessels and BMI >25, DM and male sex featured as independent predictors of CAD. Deliberate measures to prevent, timely diagnose and prompt management of CAD are warranted.