Abstract
Background: Though the presence of three-vessel disease (3VD) among patients with non-ST Segment Elevation Myocardial Infarction (NSTEMI) is relatively common, very limited data is available regarding its clinical significance. The current study aimed to determine the frequency of 3VD among NSTEMI patients presenting at the tertiary care hospital of Karachi, Pakistan.Methodology: This cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi from August 15 2015 to February 15 2016 over a sample of 139 NSTEMI patients. Data regarding patients' baseline characteristics were recorded in a proforma. Coronary angiography was performed to determine the presence of 3VD. The frequency of occluded arteries and 3VD was also recorded and the collected data was then analyzed using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM Corp., Armonk, NY, USA).Results: A total of 139 NSTEMI patients were enrolled in the study with a mean age of 50.47 ± 12.47 years. The majority of them were males (70.5%), mostly ≥ 40 years of age (67.6%). Among the comorbidities, 50.4% of patients had diabetes mellitus (DM), 61.9% were hypertensive and 30.9% had dyslipidemia. The overall frequency of 3VD among the enrolled NSTEMI patients was 30.2%. Three major arteries were found to be occluded; 68.3% NSTEMI patients had occlusion in the left anterior descending (LAD) artery, followed by right coronary artery (RCA) among 49.6%, 40.3% had left circumflex (LCX) artery occlusion, and 50.4% had diagonal and obtuse marginal (OM) artery occlusion respectively. Among the effect modifiers, no significant impact of age, gender, and smoking habits was observed on the frequency of 3VD among NSTEMI patients (p > 0.05). Among the reported comorbidities, DM was significant among NSTEMI patients with 3VD (p < 0.05).Conclusion: Our study results indicated that a significant proportion of NSTEMI patients had 3VD, independent of the effect of age and gender.
Highlights
Coronary artery disease (CAD) with its massive frequency has become a major public health concern and is among the leading causes of morbidity and mortality worldwide [1,2]
No significant impact of age, gender, and smoking habits was observed on the frequency of 3VD among non-ST Segment Elevation Myocardial Infarction (NSTEMI) patients (p > 0.05)
diabetes mellitus (DM) was significant among NSTEMI patients with 3VD (p < 0.05)
Summary
Coronary artery disease (CAD) with its massive frequency has become a major public health concern and is among the leading causes of morbidity and mortality worldwide [1,2]. The ACS further sub-divides as ST Segment Elevation Myocardial Infarction (STEMI) and Non-ST Segment Elevation Myocardial Infarction (NSTEMI) which is relatively more common and is one of the major reasons behind ACS-associated hospital admissions and deaths [3,4]. Both STEMI and NSTEMI are characterized by occlusion of one or more culprit arteries, but the condition is known to be less severe among NSTEMI patients, which may be due to the incomplete occlusion of the culprit arteries as compared to STEMI cases where arteries undergo complete occlusion [5,6]. The current study aimed to determine the frequency of 3VD among NSTEMI patients presenting at the tertiary care hospital of Karachi, Pakistan
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