To study Incidence of Coronary Artery Disease in Asymptomatic Chronic Smokers by Using Exercise Stress Test
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 5
Abstract
Introduction: Identification of coronary artery disease (CAD) in asymptomatic individuals is helpful in preventing future coronary events. The electrocardiographic exercise test is an easy, non-invasive, and reliable method for the diagnosis of latent CAD. Purpose: The purpose of the study was to study the incidence of CAD in asymptomatic chronic smokers using exercise stress test, relationship between CAD risk and duration of smoking and to study the effect of smoking as an independent risk factor for CAD. Materials and Methods: This study was conducted on 82 asymptomatic chronic smokers (duration of smoking at least 10 years and number of bidis/cigarettes >5 per day). Persons having history of angina pectoris, history of myocardial infarction, family history of IHD, significant abnormalities in the resting electrocardiogram, history of diabetes mellitus, history of hypertension, hypercholesterolemia, and severe non-cardiac disease were excluded from the study. Smoking history was taken with reference to years of smoking, type of smoking, and number of bidis/cigarettes per day. Study patient underwent exercise stress test as per modified Bruce protocol and other relevant blood investigations. Results: In non-smoker group, only 7.3% subjects observed with positive treadmill test (TMT) but in bidi and cigarette smoker group positive TMT was observed in 33.3% and 39.1%, respectively. Inadequate exercise was noted in about 40% in smokers group while negative TMT was noticed in 20% in this group. The positive finding of TMT was strongly associated with smokers group (P < 0.0001). The study revealed that about 80% of non-smokers achieved the target heart rate while only 24.39% of smokers could achieve that and this is statistically highly significant (P < 0.0000I). Non-smoker group has good exercise effort tolerance with an average of 10.74 ± 4.18 METS while smokers reported to have intermediate exercise effort tolerance with an average of 7.79 ± 4.55 METS. Among the chronic smokers and non-smokers, no subject developed any arrhythmias or cardiac decompensation during or after TMT. The mean pack-year (1 pack of bidi/cigarette = 10 bidis/cigarettes) of negative and positive cases was 24.12 ± 20.55 and 64.61 ± 15.45 (P < 0.001) and it was statistically significant. Conclusion: This study concluded that chronic heavy smoking is an independent major risk factor for CAD and is about 5 times more frequently associated with the positive TMT and incidence of positive TMT is directly proportional to years of smoking (P < 0.001). Exercise electrocardiography is an important non-invasive tool for detection of latent CAD.
Authors and Affiliations
Mohd Suhel Siddiqui, Lalit Jain, Arpita Shrivastav, Shivesh Thakur
Keywords
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