Frequency of Multivessel Severe Coronary Artery Disease in Patients With Non-ST Segment Elevation Myocardial Infarction Having Markedly Raised Cardiac Troponin T

Abstract

Introduction Non-ST segment elevation myocardial infarction (NSTEMI) is becoming more common than ST segment elevation myocardial infarction (STEMI) and data regarding presence of underlying multivessel coronary artery disease (MVCAD) in these patients is consistent in locoregional population that leads to lethal delays in proper management. Therefore, in the current study, we aimed to evaluate the frequency of MVCAD in NSTEMI with markedly raised troponin T levels. This will help to identify patients that should be labeled as high risk and must be referred for coronary revascularization on priority basis, so that clinical outcomes can be improved in these patients. Methods This cross-sectional research study was carried out at Chaudhary Pervaiz Elahi Institute of Cardiology, Multan over a period of one year. A total of 326 patients with history of chest discomfort within past 48 hours of presentation or angina equivalent symptoms and cardiac troponin T more than 500 ng/l were included in the study. Coronary angiography was done within 72 hours of same hospital admission. The outcome variable i.e. MVCAD was determined. Results Mean age of patients was 50.74 ± 7.75 years with range of 30 to 60 years. MVCAD was found in 107 (32.82%) patients, whilst there was no MVCAD in 219 (67.18%) patients. Moreover, no significant association of MVCAD was noted with age or smoking.

Risk Assessment of Patients After ST-Segment Elevation Myocardial Infarction by Killip Classification: An Institutional Experience

“…However, Pakistan is a resource limited country with lack of well developed screening programs due to which patients present late, leading to high rate of complications like left ventricular thrombosis [12]. Moreover, frequency of multi-vessel disease even in the absence of ST segment elevation on electrocardiogram is high [13]. Our results showed that diabetes and smoking were signi cantly associated with MI.…”

Risk Assessment of Patients After ST-Segment Elevation Myocardial Infarction by Killip Classification: An Institutional Experience

“…However, Pakistan is a resource-limited country with a lack of well-developed screening programs due to which patients present late, leading to a high rate of complications, like left ventricular thrombosis [ 13 ]. Moreover, the frequency of multi-vessel disease, even in the absence of ST-segment elevation on the electrocardiogram, is high [ 14 ].…”

Ischemia-Modified Albumin: Origins and Clinical Implications

“…The advances in the study of heart diseases have led to the discovery of a broad range of novel biomarkers associated with cardiovascular risks, including cTnI and cTnT, B-type natriuretic peptide (BNP) and its prohormone NT-proBNP, C-reactive protein (CRP), myeloperoxidase (MPO), lipoprotein-associated phospholipase A2, miRNA, matrix metalloproteinases, and cystatin C [69,70]. Although these biomarkers have a prognostic value independent of the previous traditional risk factors, they have some limitations as early markers for ACS, including unstable angina, non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI) [69,71].…”