Abstract

Although coronary artery disease is a well recognized clinical entity and very common in India, there is paucity of literature on the patients undergoing surgical revascularization in the form of coronary artery bypass grafting (CABG) at a young age (<40 years). The aim of this study is to analyze the details of patients with premature coronary artery disease (PCAD) who underwent CABG at a tertiary care cardiac center in India. A retrospective observational study was conducted for the present study. All patients aged <40 years with Premature Coronary artery disease (PCAD) were registered in the PCAD Registry at Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore. The electronic database of case records of all patients with PCAD who underwent CABG at Sri Jayadeva Institute of Cardiovascular Sciences and Research, between April 2018 and March 2019 was analyzed. Patients were selected based on the database of PCAD registry at our institute under CTRI regulation of India (registration number CTRI/2018/03/012544), All patients were diagnosed with Coronary angiogram (CAG) and required further treatment in the form of CABG. Binary logistic regression was used to test the hypothesis (n= 100) cases, out of which LIMA was grafted in 84 cases (n=84), (odd ratio 3.55); of which LIMA to LAD was grafted in 81 cases (n=81); LIMA to RIMA –OM1 was grafted in 2 cases (n=2) , and LIMA - Radial - Y was grafted in 1 case (n=1). Off - pump CABG (OPCAB) was done in 79 cases (79%) and the remaining cases were operated On - pump. Most common conduits that were used for grafting in CABG were LIMA (84%); SVG (82%), RIMA (9%) and radial artery (1%). Mean Ejection Fraction was 51.28%, with Standard Deviation (SD) of 5.80. Carotid artery stenosis (> 50%narrowing of the internal carotid artery) was seen in 11% of the cases. Peripheral Arterial Disease (PAD) was seen in 4% of cases (odds 1.18). Mortality rate (CFR) was negatively correlated in the younger population; deaths were seen in only 2 cases (n =2). The extent of CABG characteristics was positively correlated and statistically significant (p=0.001). In conclusion, Cardiovascular Disease (CVD) risk is more common in resource-poor and developing countries. Considering all the research findings, the present study concludes that CABG surgery can be treated with comparable components for the management of patients diagnosed to be suffering from Coronary artery disease below the age of 40 years. Relative long-term survival rate after CABG surgery, regardless of gender needs to be assessed for over a period of time at the population level

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