The epidemiological and clinical characteristics of patients admitted for coronary angiography to evaluate ischemic heart disease

Abstract

Background: Most of the known risk factors associated with ischemic heart disease are based on studies from Western countries; there is only limited information on Korean populations. This study was designed to analyze age related differences in epidemiologic and clinical characteristics in patients who were admitted for coronary angiography for the evaluation of ischemic heart disease.

Methods: As part of the multicenter KCAR (Korean Coronary Artery disease Registry) Study, the clinical data of 6,549 patients, who were evaluated at the cardiac catheterization laboratory by coronary angiography, at seven university hospitals in Korea from March 1999 to December 2005, were registered into the KCAR database and analyzed. All patients were divided into three groups according to age: age < or = 40, age 41-70 and age > or = 71. All demographic and coronary angiographic features were analyzed for the different groups.

Results: The demographic data showed that compared to the older patients young patients < or = 40 had a higher prevalence of males and smokers, but a lower prevalence of hypertension, diabetes and prior history of stroke and myocardial infarction. For the lipid profiles, the younger patients had much higher levels of total cholesterol, triglycerides and LDL-cholesterol than the older groups; however, there was no difference in the HDL-cholesterol levels among the three age groups. The most common component of the metabolic syndrome was obesity (79%) in the younger patients and hypertension (92%) in the older patients. The most common reason for presentation was ST-segment elevated myocardial infarction in the younger patients and unstable angina in the older patients.

Conclusions: Ischemic heart disease in younger adults < or = 40 had different demographic characteristics and clinical presentation than older patients.

Figure 1

Age distribution of the study patients. About one third of the patients were older >70; patients <41 accounted for only 2.1%.

Figure 2

The prevalence of risk factors for ischemic heart disease. While younger patients showed a higher prevalence of male gender and smoking, older patients had a higher incidence of diabetes and hypertension. HTN, hypertension; DM, diabetes mellitus; CVA, cerebrovascular accident.

Figure 3

The distribution of the extent of coronary artery disease. Most of the younger patients showed minimal stenosis or significant stenosis in one vessel. Coronary atherosclerosis was extensive in older patients as revealed by the higher incidence of 2 or 3 vessel disease.

Figure 4

Distribution of clinical presentation of ischemic heart disease. Younger patients were more likely to present with myocardial infarction than older patients were. NSTEMI, non ST-segment elevated myocardial infarction; STEMI, ST-segment elevated myocardial infarction.

Figure 5

In-hospital management of significant coronary artery stenosis (≥=50% diameter stenosis) by different ages (n=5150). The treatment strategies were similar for all age groups. About 84% of ischemic heart disease patients with significant stenosis of the coronary artery were treated with percutaneous coronary intervention. PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft surgery.