Angiographic Findings in Patients Presented with Inferior Wall Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Authors

  • Waseem Iqbal Department of Cardiology, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Ikramullah Department of Cardiology, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Muhammad Azam Khan Department of Cardiology, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Atif Kamal Department of Cardiology, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Roman Khan Department of Cardiology, Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Tilawat Khan Department of Cardiology, Hayatabad Medical Complex, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i7.2223

Keywords:

Inferior Wall Myocardial Infarction, Coronary Angiography, Left Anterior Descending Artery, Left Circumflex Artery, Right Coronary Artery

Abstract

Background: Inferior wall myocardial infarction is a prevalent subtype of acute myocardial infarction, often associated with variable coronary artery involvement. Angiographic evaluation remains a critical tool for identifying the culprit vessel and guiding revascularization strategies. Objective: To determine the frequency of angiographic findings in patients presented with inferior wall myocardial infarction. Study Design: Cross-sectional study. Duration and Place of Study: The study was conducted from January to May 2025 at the Department of Cardiology, Lady Reading Hospital, Peshawar. Methodology: A total of 131 patients aged 18–75 years presenting with inferior wall myocardial infarction and undergoing coronary angiography within 24 hours were enrolled. Patients with advanced comorbidities, cardiogenic shock, or contraindications to angiography were excluded. Demographic and clinical data including age, gender, body mass index, socioeconomic status, and residential background were recorded. Coronary arteries were classified as diseased when 50% or greater luminal narrowing was observed. Results: The mean age was 53.01±9.03 years, and most patients were male (77.1%). Left anterior descending artery involvement was observed in 53.4%, left circumflex artery in 24.4%, and right coronary artery in 46.6% of cases. Significant associations were found between left anterior descending artery disease and both age (p=0.003) and socioeconomic status (p<0.001). Left circumflex artery involvement was significantly associated with age (p=0.018). Conclusion: Coronary angiography in inferior wall myocardial infarction revealed notable variability in arterial involvement, with age and socioeconomic status influencing disease distribution.

Downloads

Download data is not yet available.

References

1. Narváez Orozco, A., Navarro Navajas, A., Cardona Buitrago, C., Senior-Sánchez, J. M., Ortiz Uribe, J. C., & Delgado Restrepo, J. A. (2024). Síndrome coronario agudo de origen embólico, reporte de Caso. Archivos Peruanos de Cardiología y Cirugía Cardiovascular, 5(1), 45-49.

https://doi.org/10.47487/apcyccv.v5i1.347

2. Ng, I. K., Chia, Y. W., See, K. C., & Teo, D. B. (2024). Approach to acute chest pain and acute coronary syndrome in adults. Singapore Medical Journal, 65(2), 111-118.

https://doi.org/10.4103/singaporemedj.smj-2023-039

3. Nikus, K., Birnbaum, Y., Fiol-Sala, M., Rankinen, J., & De Luna, A. B. (2021). Conduction disorders in the setting of acute STEMI. Current Cardiology Reviews, 17(1), 41-49.

https://doi.org/10.2174/1573403x16666200702121937

4. Gholipour, M., Noruzi, S., Moayerifar, M., Khalili, A., Eftekhari, B., Mirbolouk, F., Kheirkhah, J., Salari, A., Hassandokht, T., & Ghasemzadeh, G. (2025). The effect of extent and localization of precordial ST-segment depression in acute inferior myocardial infarction as an indicator of infarct severity, coronary artery involvement, and cardiac outcomes. Therapeutic Advances in Cardiovascular Disease, 19.

https://doi.org/10.1177/17539447251326154

5. Abubakar, M., Javed, I., Rasool, H. F., Raza, S., Basavaraju, D., Abdullah, R. M., Ahmed, F., Salim, S. S., Faraz, M. A., Hassan, K. M., & Hajjaj, M. (2023). Advancements in percutaneous coronary intervention techniques: A comprehensive literature review of mixed studies and practice guidelines. Cureus.

https://doi.org/10.7759/cureus.41311

6. Haider, K. H., Alshoabi, S. A., Alharbi, I. A., Gameraddin, M., Abdulaal, O. M., Gareeballah, A., Alsharif, W. M., Alhazmi, F. H., Qurashi, A. A., Aloufi, K. M., & Sayed, A. I. (2023). Clinical presentation and angiographic findings of acute myocardial infarction in young adults in Jazan region. BMC Cardiovascular Disorders, 23(1).

https://doi.org/10.1186/s12872-023-03335-3

7. Hage, G., Reibel, I., Dib, J. C., Beverelli, F., Allouch, P., Makowski, S., & Rosencher, J. (2021). Double culprit lesions in a patient with ST-segment elevation myocardial infarction. JACC: Case Reports, 3(18), 1906-1910.

https://doi.org/10.1016/j.jaccas.2021.07.028

8. Yang, P., Zhang, S., Yin, X., Zhang, Y., Zhu, H., Cao, Y., & Shen, C. (2025). Myocardial infarction with nonobstructive coronary arteries (MINOCA): A narrative review. European Journal of Medical Research, 30(1).

https://doi.org/10.1186/s40001-025-02703-3

9. Onnis, C., Virmani, R., Kawai, K., Nardi, V., Lerman, A., Cademartiri, F., Scicolone, R., Boi, A., Congiu, T., Faa, G., Libby, P., & Saba, L. (2024). Coronary artery calcification: Current concepts and clinical implications. Circulation, 149(3), 251-266.

https://doi.org/10.1161/circulationaha.123.065657

10. Damluji, A. A., Gangasani, N. R., & Grines, C. L. (2022). Mechanical complication of acute myocardial infarction secondary to COVID-19 disease. Cardiology Clinics, 40(3), 365-373.

https://doi.org/10.1016/j.ccl.2022.05.001

11. Komatsu, J., Nishimura, Y., Sugane, H., Hosoda, H., Imai, R., Nakaoka, Y., Nishida, K., Seki, S., Kubo, T., Yamasaki, N., Kitaoka, H., Kubokawa, S., Kawai, K., Hamashige, N., & Doi, Y. (2022). Acute left circumflex coronary artery Occlusion ― diagnostic problems of initial Electrocardiographic changes ―. Circulation Reports, 4(10), 482-489.

https://doi.org/10.1253/circrep.cr-22-0044

12. Dave, D. M., Ferencic, M., Hoffmann, U., & Udelson, J. E. (2014). Imaging techniques for the assessment of suspected acute coronary syndromes in the emergency department. Current Problems in Cardiology, 39(7), 191-247.

https://doi.org/10.1016/j.cpcardiol.2014.05.002

13. Buonpane, A., Trimarchi, G., Ciardetti, M., Coceani, M. A., Alagna, G., Benedetti, G., Berti, S., Andò, G., Burzotta, F., & De Caterina, A. R. (2024). Optical coherence tomography in myocardial infarction management: Enhancing precision in percutaneous coronary intervention. Journal of Clinical Medicine, 13(19), 5791.

https://doi.org/10.3390/jcm13195791

14. Alsagaff, M. Y., & Kusumawardhani, N. (2021). Wrapped left anterior descending artery STEMI: Time to revisit. BMJ Case Reports, 14(1), e237839.

https://doi.org/10.1136/bcr-2020-237839

15. Kesieme, E. B., Iruolagbe, C., Omoregbee, B. I., & Inuwa, I. M. (2024). Basic overview of conventional coronary angiography for planning cardiac surgery. Cureus.

https://doi.org/10.7759/cureus.52942

16. Shahidul Haque, S. M., Morshedul Ahsan, M., Sarker, Md, A. C., Hossain, Md, S., Baqar Md, A., & Kabir, J. S. (2023). Correlation between ECG changes and coronary Angiographic findings in patient with inferior myocardial infarction in a tertiary care hospital. Cardiology and Cardiovascular Medicine, 07(02).

https://doi.org/10.26502/fccm.92920313

17. Santa-Ana-Bayona, M. J., Ponce-Acosta, C., Acosta-Gutiérrez, G. H., Pardiño-Vega, M. Á., Garcia-Cadernas, M., Ruiz-Mori, E., Martinez-Jimenez, N., Guerra, E. C., & Espinola-Zavaleta, N. (2025). Wrap-around LAD and the role of multimodal imaging. Radiology Case Reports, 20(7), 3420-3424.

https://doi.org/10.1016/j.radcr.2025.04.018

18. Ramzan, M., Zab, J., Javed, M. K., & Ali, F. (2018). Acute inferior wall myocardial infarction. The Professional Medical Journal, 25(02), 287-291.

https://doi.org/10.29309/tpmj/2018.25.02.458

19. Ghosh, S., Mukhopadhyay, S., & Patra, T. (2022). Angiographic correlates of acute ST elevation inferior wall myocardial infarction with or without right ventricular involvement. Cardiology and Cardiovascular Research, 6(1), 45.

https://doi.org/10.11648/j.ccr.20220601.17

20. Khan, M. H., Islam, M. N., Ahmed, M. U., Shafique, A. M., Bari, M. S., Islam, M. Z., ... & Siddique, S. R. (2016). Comparison between Angiographic Findings of Coronary Artery Disease in STEMI and NSTEMI Patients of Bangladesh. Mymensingh medical journal: MMJ, 25(2), 221-225.

https://europepmc.org/article/med/27277351

21. Sheikh L, Umer I, Arif Z. Prevalence of Cerebral Aneurysms Detected by CT Angiography in Patients with Subarachnoid Hemorrhage: A Cross-Sectional Study from Karachi. Pakistan Journal of Clinical Research. 2024;1(1):1-5.

22. Acuña-Román, A., Vindas-Villarreal, M. A., & Salas-Segura, D. A. (2021). Perfil clínico Y angiográfico de las mujeres con infarto agudo al miocardio en UN hospital nacional. Acta Médica Costarricense, 63(2), 97-103.

https://doi.org/10.51481/amc.v63i2.1186

Downloads

Published

2025-07-15

How to Cite

Iqbal, W., Ikramullah, Khan, M. A., Kamal, A., Khan, R., & Khan, T. (2025). Angiographic Findings in Patients Presented with Inferior Wall Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Indus Journal of Bioscience Research, 3(7), 948-953. https://doi.org/10.70749/ijbr.v3i7.2223