Pattern of Coronary Artery Disease in Patients Presenting with Acute Coronary Syndrome at Peshawar Institute of Cardiology

Shah Sawar Khan; Rafiullah Jan

doi:10.70749/ijbr.v3i3.709

Authors

Shah Sawar Khan Department of Cardiology, Peshawar Institute of Cardiology, Pakistan.
Rafiullah Jan Department of Cardiology, Peshawar Institute of Cardiology, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i3.709

Keywords:

Coronary artery disease, Acute Coronary Syndrome, Risk Factors, Cardiovascular Prevention

Abstract

Background: Left main coronary artery (LMCA) disease in patients with Acute Coronary Syndrome (ACS) is a serious clinical entity associated with poor short-term outcomes. Despite its well-established prognostic implications, the frequency and impact of LMCA disease in ACS patients remain underexplored. Identifying demographic, clinical, and health-related factors associated with adverse outcomes is essential for improving patient management. Objective: This study aimed to evaluate the frequency of left main coronary artery disease and assess its association with in-hospital outcomes in ACS patients. Methods: A descriptive cross-sectional study was conducted involving 145 patients with ACS, including 80 with STEMI (ST-Elevation Myocardial Infarction) and 65 with non-STEMI. Baseline demographic and clinical characteristics were collected, including age, gender, comorbidities (e.g., diabetes, hypertension, dyslipidemia), and lifestyle factors (e.g., smoking). In-hospital outcomes, including arrhythmias, intra-aortic balloon pump (IABP) use, length of hospital stay, and mortality, were analyzed. Statistical associations were assessed using Chi-square tests and multivariable regression analysis. Results: The majority of patients (37.9%) were aged 60–70 years, and 55.2% were male. Comorbidities included diabetes (37.9%), hypertension (48.3%), and dyslipidemia (41.4%). STEMI was the predominant ACS type (55.2%), and 41.4% of patients experienced arrhythmias. IABP support was required in 27.6% of cases, and 10.3% of patients died. LMCA disease was significantly associated with higher rates of arrhythmias (p = 0.003), increased need for IABP (p = 0.000), longer hospital stays (p = 0.000), and higher mortality (p = 0.001). Additionally, diabetes (p = 0.004) and hypertension (p = 0.021) were also independently linked to adverse outcomes. Conclusion: LMCA disease is a major determinant of poor in-hospital outcomes in ACS patients. Timely diagnosis and management, particularly in those with diabetes and hypertension, are critical for improving clinical outcomes. Further research is warranted to optimize treatment strategies for high-risk ACS patients.

Downloads

Download data is not yet available.

References

Estrada, E. A. C., Sequeda, E. R. M., Barros, J. E. B., Ríos, J. A. C., Segura, I. M. R., & Barreto, G. L. L. (2024). Acute coronary syndrome: Definition, pathophysiology, diagnosis, and management. World Journal of Advanced Research and Reviews, 21(1), 2537-2548. https://doi.org/10.30574/wjarr.2024.21.1.0352

Damluji, A. A., Forman, D. E., Wang, T. Y., Chikwe, J., Kunadian, V., Rich, M. W., ... & Alexander, K. P. (2023). Management of acute coronary syndrome in the older adult population: a scientific statement from the American Heart Association. Circulation, 147(3), e32-e62. https://doi.org/10.1161/cir.0000000000001112

Ross, M., & Cedarholm, J. (2023). ACS Non-ST Elevation Myocardial Infarction (NSTEMI). In Cardiovascular Manual for the Advanced Practice Provider: Mastering the Basics (pp. 31-41). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-35819-7_4

Bubulytė, S., & Maneikienė, V. V. (2024). Acute coronary syndromes–ST-elevation myocardial infarction and non-ST elevation myocardial infarction–literature review. Medicinos mokslai, 12(3), 118-124.

Rabadia, J. P., Thite, V. S., Desai, B. K., Bera, R. G., & Patel, S. (2024). Cardiovascular System, Its Functions and Disorders. In Cardioprotective Plants (pp. 1-34). Singapore: Springer Nature Singapore. https://doi.org/10.1007/978-981-97-4627-9_1

Ullah, M., Wahab, A., Khan, S. U., Zaman, U., ur Rehman, K., Hamayun, S., ... & Refat, M. S. (2023). Stent as a novel technology for coronary artery disease and their clinical manifestation. Current Problems in Cardiology, 48(1), 101415. https://doi.org/10.1016/j.cpcardiol.2022.101415

Kucia, A. M., Beltrame, J. F., & Keenan, J. (2022). Chest pain assessment. Cardiac Care: A Practical Guide for Nurses, 216-230. https://doi.org/10.1002/9781119117810.ch14

Aniyathodiyil, G., & Chopra, S. (2024). Emergencies in Cardiovascular System A. An Approach to Acute Chest Pain. Emergencies in Medicine, 110.

Ji, N. (2024). Chest Pain. In Visceral Pain: From Bench to Bedside (pp. 183-198). Singapore: Springer Nature Singapore. https://doi.org/10.1007/978-981-99-9167-9_10

Chhabra, V., & Nickson, A. (2023). Chest pain. RCEM Lecture Notes: Emergency medicine, 184-204. https://doi.org/10.1002/9781394323289.ch12

From Kliegman, R. M., St Geme III, J. W., & Blum, N. J. (2022). 110 SECTION 3 Cardiac Disorders. Nelson Pediatric Symptom-Based Diagnosis E-Book, 109.

Chung, F., & Roy, L. (2024). Cardiovascular Conditions. In Cardiopulmonary Physical Therapy (pp. 53-76). Routledge. https://doi.org/10.4324/9781003522829-4

Fishbein, G. A., Fishbein, M. C., Wang, J., & Buja, L. M. (2022). Myocardial ischemia and its complications. In Cardiovascular pathology (pp. 407-445). Academic Press. https://doi.org/10.1016/b978-0-12-822224-9.00022-0

Zhang, G., Cui, J., Zhang, X., Chair, S. Y., Liu, W., Liu, Y. J., ... & Zou, H. (2024). Relationships between disease severity, psychological stress, and health-related quality of life among patients with acute coronary syndrome: mediation of illness perception. European Journal of Cardiovascular Nursing, 23(6), 652-660. https://doi.org/10.1093/eurjcn/zvae030