Abstract
PATTERN OF CORONARY ARTERY INVOLVEMENT IN PATIENTS WITH ACUTE CORONARY SYNDROME (ST SEGMENT ELEVATION MYOCARDIAL INFARCTION)

*Dr. Bhawani Manandhar, Dr. Prashant Shah, Dr. Sanjib Kumar Sharma and Dr. Prahlad Karki

ABSTRACT

Aims: The aim was to study the pattern of coronary artery involvement in the patients presenting as Acute Coronary Syndrome - ST segment Elevation Myocardial Infarction (ACS-STEMI) in BPKIHS, Dharan. Material and Methods: This is a retrospective, descriptive study. A total of 50 consecutive patients of ACS-STEMI who underwent Percutaneous Coronary Intervention were analyzed for the pattern of coronary artery involvement at BPKIHS, Dharan. Results: Out of 50 patients of ACS (STEMI), anterior wall MI was present in 31 (62%), inferior wall MI was present in 19 (38%). SVD was present in 56%, DVD was present 28% and TVD was present in 16% of the patients with ACS (STEMI). Among 28 patients with SVD, LAD was the most common infarct related artery (IRA) in 18 patients (64.2%), RCA in 9 (32.1%) and LCX in 2 patients (7.14%). In patients with DVD, overall 78.5% had lesions in LAD and RCA, 14.3% had lesions in RCA and LCX and 7.14% had lesions in LAD and LCX. In patients anterior wall MI with TVD (6 patients- 19.35%), tubular to diffuse lesion with 80-100% occlusion of LAD, along with 70-80% stenosis of LCX and 50-90% stenosis of RCA were present. In 2 patients (10.52%) with inferior wall MI and TVD, there were total occlusion of RCA along with 70-80% stenosis of LAD and RCA. Conclusion: Anterior wall MI is more common than inferior wall MI. In patients presenting with anterior wall MI, single vessel disease is more common than DVD or triple vessel disease. LAD is the most common infarct related artery in anterior wall MI, and RCA is the most common infarct related artery in inferior wall MI. Total or subtotal thrombotic occlusion of Proximal LAD and Mid RCA are the most common lesions in patients with ACS (STEMI). Male gender, increased age, hypertension, diabetes mellitus, dyslipidemia, smoking are the well known risk factors of ACS (STEMI). In patients with diabetes mellitus DVD and TDV are more common than SVD.

Keywords: ACS, STEMI, MI, CAG, LAD, LCX, RCA, SVD, DVD, TVD.


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