Prevalence of Coronary Artery Disease and Its Risk Factors in Patients Undergoing Permanent Pacemaker Implantation

Objective: To determine prevalence of CAD and its risk factors among patients undergoing permanent pacemaker implantation (PPI). Methods: This prospective, single-center hospital based study examined patients >40 years of age, who required PPI.  Presence of atherosclerotic risk factors and CAD was examined. Results: Of 258 patients undergoing PPI, CAD was present in 50 (19.4%) patients. CAD was more common among middle age and elderly patients (P=0.032). Patients with age ≥50.5 years had sensitivity of 96.0% for an association with CAD. Multivariate analysis showed that age (odds ratio: 1.042; 95% confidence interval: 1.009–1.075; P=0.011) and diabetes (odds ratio: 3.437; 95% confidence interval: 1.618–7.303; P=0.001) had a statistically significant association with CAD. Of 31 patients with involvement of left anterior descending (LAD), 28 (43.1%) had associated atrioventricular (AV) nodal disease (P=0.01), suggesting an association between LAD disease and chronic degenerative changes in the AV node. Conclusion: CAD was present in 19.4% patients undergoing PPI. Age and diabetes have strong association with CAD. LAD stenosis was significantly associated with AV nodal/ infra-hisian disease.