Frequency of Three-Vessel Disease Among Patients With Non-ST Segment Elevation Myocardial Infarction
Faisal Ahmed1, Muhammad Sami Khan2, Syed Dilbahar Ali Shah1
1Cardiology, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK.
Insights
Three-vessel disease (3VD) affects nearly a third of non-ST Segment Elevation Myocardial Infarction (NSTEMI) patients. Diabetes Mellitus significantly increases the risk of 3VD in NSTEMI patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Three-vessel disease (3VD) is a common finding in patients with non-ST Segment Elevation Myocardial Infarction (NSTEMI).
- Limited data exists on the clinical significance and frequency of 3VD in NSTEMI patients, particularly in South Asia.
- This study investigates the prevalence of 3VD in NSTEMI patients at a tertiary care hospital in Karachi, Pakistan.
Purpose of the Study:
- To determine the frequency of three-vessel disease (3VD) in patients diagnosed with non-ST Segment Elevation Myocardial Infarction (NSTEMI).
- To analyze the association of comorbidities, particularly diabetes mellitus, with the presence of 3VD in NSTEMI patients.
- To assess the impact of demographic factors like age and gender on the occurrence of 3VD in this patient cohort.
Main Methods:
- A cross-sectional study involving 139 NSTEMI patients was conducted at the National Institute of Cardiovascular Diseases, Karachi.
- Data on patient demographics and comorbidities were collected, and coronary angiography was performed to diagnose 3VD.
- Statistical analysis, including SPSS version 20.0, was used to analyze the frequency of 3VD and occluded arteries.
Main Results:
- The overall frequency of 3VD among NSTEMI patients was 30.2%.
- The most commonly occluded arteries were the left anterior descending (LAD) and right coronary artery (RCA).
- Diabetes Mellitus was found to be a significant comorbidity associated with 3VD in NSTEMI patients (p < 0.05).
Conclusions:
- A significant proportion of NSTEMI patients present with three-vessel disease.
- The presence of 3VD in NSTEMI patients is independent of age and gender.
- Diabetes Mellitus is a key risk factor for 3VD in the context of NSTEMI.
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.
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