Cardiology & Vascular Research


Angiographic Pattern of Coronary Artery Disease in Pre-Menopausal Indian Women: A Single Centre Study

Soman Biji, Rahaman Muneer A, Rajan Rajesh, Vijayaraghavan Govindan.

Background: Coronary Artery Disease (CAD) is increasingly becoming the disease of the young. Not much is known regarding the incidence, degree and pattern of CAD in pre-menopausal Indian women. Our aim was to study the prevalence and pattern of CAD among pre-menopausal women undergoing CAG.

Methods: Data of 100 women who underwent CAG for suspected CAD over 2 years were retrospectively analyzed. They were classified into pre-menopausal group (age ≤ 50 years) and post-menopausal group (age ≥ 60 years). Risk factor profile and coronary angiographic profile of these patients were studied and compared. 

Results: The mean age of pre-menopausal women was 45.8 ± 4.2 years and 67.4 ± 6.4 years was the mean age of the post-menopausal women. Hypertension was the commonest risk factor in both the groups, with significantly higher incidence of hypertension in the post-menopausal group (24 vs. 41, p = 0.0029). Greater number of premenopausal women CAD with none of the risk factors, (15 vs. 04, p = 0.0004). There was a greater prevalence of obstructive CAD (31 vs. 15, p<0.0013) among post-menopausal women, especially triple vessel disease (TVD) (3 vs. 15, p = 0.0018). Left anterior descending (LAD) artery is the most commonly affected vessel. Proximal segment was the most frequently affected segment of the coronary artery.

Conclusion: Pre-menopausal women had a higher percentage of angiographically normal epicardial coronaries and non obstructive CAD, and even those who had obstructive CAD; the prevalence of multi vessel disease was much less when compared with the post-menopausal women.

The risk factor profile and pattern of coronary disease in pre-menopausal women is different from the conventional picture.