Linking Clinical Presentation with Coronary Anatomy: A Study of Angina Severity and Its Relationship with Angiographic Findings in Coronary Artery Disease
Linking Clinical Presentation with Coronary Anatomy: Angina Severity and CAD
DOI:
https://doi.org/10.54393/pjhs.v7i7.4213Keywords:
Angina, Angiographic Findings, Coronary Anatomy, Coronary Artery DiseaseAbstract
No intensive studies have been conducted locally or even in broader regions of the country, which results in a crucial knowledge gap in the establishment of the relationship between the severity of angina and the angiographic findings in patients with coronary artery disease (CAD). Objectives: To determine the correlation of angina severity with angiographic findings in patients diagnosed with coronary artery disease. Methods: This cross-sectional study was carried out at the Department of Cardiology, Lady Reading Hospital, Peshawar. Male and female patients of age 30 to 70 years diagnosed with coronary artery disease were evaluated for angina severity in comparison to angiographic findings. Results: Among 304 patients, angina severity demonstrated a strong positive correlation with angiographic findings (ρ = 0.875, p<0.001). Diabetic patients with severe angina had a higher proportion of high angiographic burden (36.8%) compared to non-diabetics (10.2%), while patients with family history of CAD showed a strong correlation (ρ = 0.886) and relatively weak correlation with Type C complex lesions (ρ = 0.706). Conclusions: A strong positive correlation was observed between angina severity and angiographic CAD burden, though this relationship was modified by diabetes, family history, and lesion complexity.
References
Di Cesare M, Perel P, Taylor S, Kabudula C, Bixby H, Gaziano TA et al. The Heart of the World. Global Heart. 2024 Jan; 19(1): 11. doi: 10.5334/gh.1288. DOI: https://doi.org/10.5334/gh.1288
Theofilis P, Oikonomou E, Chasikidis C, Tsioufis K, Tousoulis D. Pathophysiology of Acute Coronary Syndromes—Diagnostic and Treatment Considerations. Life. 2023 Jul; 13(7): 1543. doi: 10.3390/life13071543. DOI: https://doi.org/10.3390/life13071543
Laera N, Malerba P, Vacanti G, Nardin S, Pagnesi M, Nardin M. Impact of Immunity on Coronary Artery Disease: An Updated Pathogenic Interplay and Potential Therapeutic Strategies. Life. 2023 Oct; 13(11): 2128. doi: 10.3390/life13112128. DOI: https://doi.org/10.3390/life13112128
Heusch G. Coronary Blood Flow in Heart Failure: Cause, Consequence and Bystander. Basic Research in Cardiology. 2022 Dec; 117(1): 1. doi: 10.1007/s00395-022-00909-8. DOI: https://doi.org/10.1007/s00395-022-00909-8
De Oliveira Laterza Ribeiro M, Correia VM, Herling de Oliveira LL, Soares PR, Scudeler TL. Evolving Diagnostic and Management Advances in Coronary Heart Disease. Life. 2023 Apr; 13(4): 951. doi: 10.3390/life13040951. DOI: https://doi.org/10.3390/life13040951
Abdullatef M, Omran M, Bitar A, Alsaid B. Prevalence of Classic and Non-Classic Pain Sites of Coronary Artery Disease: A Cross-Sectional Study. BioMed Central Cardiovascular Disorders. 2024 Aug; 24(1): 445. doi: 10.1186/s12872-024-04127-z. DOI: https://doi.org/10.1186/s12872-024-04127-z
Liu Y, Jiang W, Wang H, Xu M, Liao Y, Zhou H et al. Objective Ischemia, Subjective Angina, and Psychological Distress in Angina with No Obstructive Coronary Disease. Journal of the American Heart Association. 2024 Aug; 13(15): e034644. doi: 10.1161/JAHA.124.034644. DOI: https://doi.org/10.1161/JAHA.124.034644
Boerhout CK, Beijk MA, Damman P, Piek JJ, van de Hoef TP. Practical Approach for Angina and Non-Obstructive Coronary Arteries: A State-of-the-Art Review. Korean Circulation Journal. 2023 Aug; 53(8): 519-34. doi: 10.4070/kcj.2023.0109. DOI: https://doi.org/10.4070/kcj.2023.0109
Beştemir A, Apaydın Z, Kılınç AY. Analysis of Coronary Angiography and Revascularization Rates Made Over 5 Years in Public Institutions in Türkiye. Anatolian Journal of Cardiology. 2023 Sep; 27(9): 529. doi: 10.14744/AnatolJCardiol.2023.3112. DOI: https://doi.org/10.14744/AnatolJCardiol.2023.3112
Lunardi M, Louvard Y, Lefèvre T, Stankovic G, Burzotta F, Kassab GS et al. Definitions and Standardized Endpoints for Treatment of Coronary Bifurcations. Journal of the American College of Cardiology. 2022 Jul; 80(1): 63-88. doi: 10.1016/j.jacc.2022.04.024. DOI: https://doi.org/10.1016/j.jacc.2022.04.024
Jebari-Benslaiman S, Galicia-García U, Larrea-Sebal A, Olaetxea JR, Alloza I, Vandenbroeck K et al. Pathophysiology of Atherosclerosis. International Journal of Molecular Sciences. 2022 Mar; 23(6): 3346. doi: 10.3390/ijms23063346. DOI: https://doi.org/10.3390/ijms23063346
Meda JR, Kusima HL, Magitta NW. Angiographic Characteristics of Coronary Artery Disease in Patients Undergoing Diagnostic Coronary Angiography at a Tertiary Hospital in Tanzania. BioMed Central Cardiovascular Disorders. 2024 Feb; 24(1): 125. doi: 10.1186/s12872-024-03773-7. DOI: https://doi.org/10.1186/s12872-024-03773-7
Ng IK, Chia YW, See KC, Teo DB. Approach to Acute Chest Pain and Acute Coronary Syndrome in Adults. Singapore Medical Journal. 2024 Feb; 65(2): 111-8. doi: 10.4103/singaporemedj.SMJ-2023-039. DOI: https://doi.org/10.4103/singaporemedj.SMJ-2023-039
Santangelo G, Gherbesi E, Donisi L, Faggiano A, Bergamaschi L, Pizzi C et al. Imaging Approaches in Risk Stratification of Patients with Coronary Artery Disease: A Narrative Review. Archives of Medical Science. 2024 Jun; 21(1): 16. doi: 10.5114/aoms/188808. DOI: https://doi.org/10.5114/aoms/188808
Haider KH, Alshoabi SA, Alharbi IA, Gameraddin M, Abdulaal OM, Gareeballah A et al. Clinical Presentation and Angiographic Findings of Acute Myocardial Infarction in Young Adults in Jazan Region. BioMed Central Cardiovascular Disorders. 2023 Jun; 23(1): 302. doi: 10.1186/s12872-023-03335-3. DOI: https://doi.org/10.1186/s12872-023-03335-3
Khezri R, Dadaeen A, Nemati R, Farhadi A, Jamshidnezhad M, Shamsi K et al. Sex-Specific Angiographic Findings and Clinical Features in Patients with Myocardial Infarction. Scientific Reports. 2025 Dec. doi: 10.1038/s41598-025-27804-1. DOI: https://doi.org/10.1038/s41598-025-27804-1
Al Chaar S, Al Hajj A, Nakad P, Sarraf A, Halby J, Fakhry B et al. Severity and Distribution of Coronary Artery Disease in Lebanese Patients Undergoing Coronary Angiography: Impact of Gender and Age on Angiographic Characteristics, A Cross-Sectional Study. Medicine. 2026 Mar; 105(12): e48086. doi: 10.1097/MD.0000000000048086. DOI: https://doi.org/10.1097/MD.0000000000048086
Lowenstern A, Alexander KP, Pagidipati NJ, Hill CL, Pellikka PA, Cooper LS et al. Presenting Symptoms in Patients Undergoing Coronary Artery Disease Evaluation: Association with Noninvasive Test Results and Clinical Outcomes in the PROMISE Trial. Circulation: Cardiovascular Quality and Outcomes. 2022 May; 15(5): e008298. doi: 10.1161/CIRCOUTCOMES.121.008298. DOI: https://doi.org/10.1161/CIRCOUTCOMES.121.008298
Zafar KS. A Comprehensive Study of Etiological Factors, Clinical Presentations, and Angiographic Profiles in Elderly Patients (> 65 Years) with Acute Coronary Syndrome: Insights into Hospital Outcomes. International Journal of Life Sciences Biotechnology and Pharma Research. 2026.
Szolc P, Guzik B, Niewiara Ł, Kleczyński P, Bernacik A, Diachyshyn M et al. Tailored Treatment of Specific Diagnosis Improves Symptoms and Quality of Life in Patients with Myocardial Ischemia and Non-obstructive Coronary Arteries. Scientific Reports. 2025 May; 15(1): 18968. doi: 10.1038/s41598-025-02400-5. DOI: https://doi.org/10.1038/s41598-025-02400-5
Aghajani MH, Taherpour N, Mahjoob MP, Kachoueian N, Alipour M, Ghorbani S. Is the Prevalence of Risk Factors, Clinical Presentations and Severity of Coronary Artery Diseases (CAD) in Patients with Very Early and Premature CAD are Different from Mature CAD Patients? A Registry-Based Cross-Sectional Study. Global Epidemiology. 2024 Dec; 8: 100148. doi: 10.1016/j.gloepi.2024.100148. DOI: https://doi.org/10.1016/j.gloepi.2024.100148
Kawsar SM, Bhuyan AI, Parvez MS, Reza MM, Hanif A, Ullah L et al. Angiographic Evaluation of Coronary Artery Disease in Diabetic and Hypertensive Patients in Relation to Age and Sex. Medicine Today. 2026 Feb; 38(1): 14-8. doi: 10.3329/medtoday.v38i1.87667. DOI: https://doi.org/10.3329/medtoday.v38i1.87667
Wen ZG, Long JJ, Wang Y. Association Between Inflammatory Burden Index and Coronary Slow Flow Phenomenon in Patients with Chest Pain and No Obstructive Coronary Arteries. BioMed Central Cardiovascular Disorders. 2024 Oct; 24(1): 595. doi: 10.1186/s12872-024-04281-4. DOI: https://doi.org/10.1186/s12872-024-04281-4
Aksu F and Ahmed SA. Gensini Score’s Severity and Its Relationship with Risk Factors for Coronary Artery Disease among Patients Who Underwent Angiography in Somalia’s Largest PCI Centre. International Journal of General Medicine. 2024 Dec: 187-92. doi: 10.2147/IJGM.S384626. DOI: https://doi.org/10.2147/IJGM.S384626
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