Patterns and determinants of treatment for coronary artery disease

Objectives: To determine the clinical and coronary angiographic characteristics of patients with coronary artery disease (CAD) and the patterns and determinants of CAD treatment in Kingdom of Saudi Arabia (KSA). Methods: We conducted a cross-sectional study including 242 patients at 3 hospitals in KSA between June 2018 and June 2019. We included all patients aged ≥18 years diagnosed with CAD on angiography. We carried out a multinomial logistic regression to ascertain the determinants of treatment patterns and treatment modalities. Covariates for this multivariate analysis were selected based on univariate regressions. Results: The study population had a mean ± standard deviation of 58.3 ± 11.8 years, and 66.1% were male. The most frequent cardiovascular risk factor was diabetes (58.7%). Lesions involving the left anterior descending were reported among 68.6%, left circumflex among 51.2%, and right coronary arteries (RCA) among 48.8% of our patients. The most common treatment was the best medical therapy (lifestyle modifications and medical management), prescribed to 69.8% of patients. Patients aged ≤60 years with the left main disease or disease of the ramus had a higher likelihood of undergoing coronary artery bypass grafting (CABG). Contrarily, patients with RCA lesions were more likely to undergo a percutaneous coronary intervention (PCI). Conclusion: Patient age and anatomical localization of coronary atherosclerotic lesions were the main determinants of treatment with CABG or PCI.