Comprehensive Study of Culprit Lesions in Non-ST Elevation Myocardial Infarction (NSTEMI) Through invasive Coronary Angiography: A Cross-Sectional Study

Rayan Shah; Yasir Hayat; Muhammad Salahud Din; Summiya

doi:10.70749/ijbr.v3i2.2574

Authors

Rayan Shah Department of Cardiology, Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Yasir Hayat Department of Cardiology, Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Muhammad Salahud Din Department of Cardiology, Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Summiya Medical C Ward, Department of Medicine, Hayatabad Medical Complex, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i2.2574

Keywords:

Angiography, NSTEMI, Culprit Lesions.

Abstract

Background: Non-ST elevation myocardial infarction is the leading cause of morbidity and mortality. It is essential to identify and explain the culprit lesions in NSTEMI patients for treatment and successful outcomes. Objective: The aim of this study was to comprehensively study culprit lesions in Non-ST elevation myocardial Infarction through invasive coronary angiography. Materials and method: “The present cross-sectional observational study was carried out at the department of cardiology Hayatabad medical complex Peshawar over a period of six months from March 2024 to August 2024 after taking permission from the ethical committee of the institute.”Consecutive non probability sampling technique was used and sample size of 139 was calculated using WHO calculator. Individuals of both genders and different age groups (ranged 18-80 years) diagnosed with NSTEMI were included. After obtaining informed consent, eligible patients were admitted to the study. Patients were subjected to invasive Coronary Angiography in order to ascertain the details of angiographic findings. Data was analyzed using SPSS version 23. Mean + SD/Median (lQR) was calculated for quantitative variables like age, duration of symptoms and BMI. Frequencies and percentages were calculated for gender, residence, social class, occupation status and characteristics of culprit lesions. Characteristics of culprit lesions were stratified by age groups, gender, social class, occupation status, residence and BMI to see effect modifiers. Post stratification chi square test or Fischer Exact Test were applied keeping P value < 0.05 as significant. All the results were presented in tables and or graphs. Results: A total of 139 individuals with NSTEMI were included in this study out of which 103(74.10%) were male and 36(25.90%) were females. The mean age of the study participants was 67.2 ± 11.8 years. Mean BMI of the individuals was 30.2 ± 7.1kg/m2. 80% of the participants had hypertension. Coronary angiography revealed a Culprit lesion in 120 cases (86%). Culprit lesions were most prevalent in the left anterior descending in 50 cases (41.6%) followed by left circumflex artery (LCX) in 35 cases (20.1%). The major types of culprit lesion were thrombotic lesions 45%. Out of all the cases of culprit lesions stenosis was seen in 16.6% individuals. Characteristics of culprit lesions were stratified by age groups, gender, social class, and risk factors. Culprit lesions increased with age and female gender and was statistically significant (P value < 0.05). Conclusion: The present study concluded that invasive coronary angiography is a major diagnostic tool in the study of culprit lesions in Non-ST elevation myocardial infarction. Coronary angiography revealed a culprit lesion in 86% of the study population.

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