Angiographic severity of coronary artery disease and the influence of major cardiovascular risk factors

Objective: To determine the angiographic severity of coronary artery disease (CAD) and assess the influence of major cardiovascular risk factors (CVRF).Study design: a cross-sectional, hospital-based study.Setting: the catheterisation laboratory of the National Cardiothoracic Centre, Accra, Ghana.Participants: for 12 months, consecutive patients admitted for coronary angiography were assessed for the presence of CVRFs. Those with significant CAD after angiography were recruited into the study.Intervention: The patient’s angiograms were analysed, and the CAD severity was obtained using the SYNTAX scoring criteria.Main outcome measure: The lesion overall severity (SYNTAX) score and the relationship with CVRFs present.Results: out of the 169 patients that had coronary angiography, 78 had significant CAD. The mean SYNTAX score was 20.18 (SD= 10.68), with a significantly higher value in dyslipidaemic patients (p < 0.001). Pearson’s correlation between the score and BMI was weak (r= 0.256, p= 0.034). The occurrence of high SYNTAX score lesions in about 18% of the population was significantly associated with hypertension (OR= 1.304, 95% CI [1.13-1.50]; p= 0.017) dyslipidaemia (OR= 5.636, 95% CI [1.17-27.23]; p= 0.019), and obesity (OR= 3.960, 95% CI [1.18-13.34]; p= 0.021). However, after adjusting for confounding factors, only dyslipidaemia significantly influenced its occurrence (aOR= 5.256, 95% CI [1.03-26.96]; p= 0.047).Conclusion: Even though the most severe form of CAD was found in about one-fifth of the study population, its occurrence was strongly influenced by the presence of dyslipidaemia.