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Abstract
Background: Coronary artery disease (CAD) has been ranked as a major cause of morbidity and mortality across the world, and its pathogenesis is propagated by modifiable risk factors. Controllable risks of diabetes, hypertension, smoking behaviour, cholesterol and obesity greatly influence the level of severity and the advancement of CAD.
Objective: The study aimed to assess CAD using CT coronary angiography (CTCA) and determine the influence of modifiable risk factors on CAD severity.
Methodology: This cross-sectional analytical study was carried out at the Army Cardiac Hospital, Lahore, including patients aged 18 years and above who presented with chest pain. A sample was selected using a non-probability convenient sampling design with a total of 246 patients, with the prevalence of CAD being 20 percent and a confidence interval of 95 percent. The CT coronary angiography was performed to diagnose CAD by using a 128-slice GE CT scan machine. Data was collected after developing the detailed proforma containing modifiable risk factors and CAD patterns. To get the association of risk factors and CAD severity, logistic regression and the Chi-square tests were performed in SPSS version 26.
Results: In this study, 174 males and 72 females, aged 21-80 years, presented with chest pain. 130 out of a total of 246 participants had a family history. The results indicated that there was a significant correlation of diabetes (p = 0.039) and hypertension (p = <0.001) with the presence of CAD. Logistic regression analysis shows the strongest predictors of CAD were smoking and hypertension, having p values of 0.056 and <0.001, respectively. The statistically significant relationships with lesion severity and plaque burden were found for diabetes mellitus (p values 0.010, 0.008), hypertension (p values <0.001, <0.001) and total cholesterol (p = 0.001, <0.001), respectively. Vessel calcium scoring was strongly associated with diabetes and hypertension, with p-values of 0.008 and 0.034 in the given order. CAD RADS scoring was significantly associated with plaque burden (p = <0.001) in CTCA.
Conclusion: The study highlights significant associations between coronary artery disease and key risk factors, including diabetes, hypertension, smoking, and elevated cholesterol levels. Hypertension and smoking emerged as the strongest predictors of CAD. Plaque burden and lesion severity were notably influenced by these factors. CT coronary angiography proved effective in assessing disease severity and risk.
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