EVALUATING INTERVENTIONAL STRATEGIES FOR CORONARY ARTERY DISEASE IN YOUNG ADULTS: A PAKISTANI PERSPECTIVE
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Keywords
Coronary artery disease, young adults, Pakistan, percutaneous coronary intervention, major adverse cardiac events, myocardial infarction, lifestyle modification.
Abstract
Background: Coronary artery disease (CAD) is a leading cause of morbidity and mortality increasingly affecting young adults. This study investigates the incidence and management of CAD in young adults in Pakistan to provide insights into effective interventions.
Methods: An observational cohort study was conducted in multiple tertiary care hospitals in Pakistan from January 2021 to December 2023. The study included 303 young adults aged 18 to 45 years with confirmed CAD. Participants received standard medical care including lifestyle modifications, pharmacotherapy, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). Data on baseline characteristics, major adverse cardiac events (MACE), and management outcomes were collected using structured questionnaires and medical records. Statistical analysis was performed using SPSS version 26.0.
Results: The mean age of participants was 35.2 years (SD = 7.1) with 198 males (65.3%) and 105 females (34.7%). During the follow-up period, 72 participants (23.8%) experienced MACE, with a significantly higher incidence in males (30.3%) compared to females (12.4%) (p < 0.05). PCI was performed in 183 participants (60.4%) with a success rate of 92.3%, significantly reducing recurrent myocardial infarction (MI) and providing symptom relief compared to medical therapy alone and CABG (p < 0.05). Medical therapy alone was associated with a higher recurrence of MI (25.3%) and lower symptom relief (52.6%), highlighting its limitations.
Conclusion: The study reveals a significant burden of CAD among young adults in Pakistan, with males experiencing higher adverse outcomes. PCI demonstrated high efficacy as a primary intervention, emphasizing the need for early screening and targeted management strategies. Addressing modifiable risk factors through comprehensive lifestyle modification programs is crucial for improving long-term outcomes in young adults with CAD. Further research is warranted to explore long-term outcomes and the impact of socio-economic factors on access to care.
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Dr. Daud Ahmad Jan
Fellow, Interventional Cardiology, Lady Reading Hospital, Peshawar, Pakistan
Dr. Wasim Sajjad
Fellow, Interventional Cardiology, Lady Reading Hospital, Peshawar, Pakistan
Dr. Hafiz Adil Bilal
Fellow, Interventional Cardiology, Lady Reading Hospital, Peshawar, Pakistan
Dr. Rahid Ullah
Fellow, Interventional Cardiology, Lady Reading Hospital, Peshawar, Pakistan
Dr. Rahid Ayaz
Fellow, Interventional Cardiology, Lady Reading Hospital, Peshawar, Pakistan
Dr. Fahad Raja Khan
Fellow, Interventional Cardiology, Peshawar, Pakistan