Frequency of Multivessel severe coronary artery Disease in patients with Non-ST elevation Myocardial Infarction ( NSTEMI) with markedly raised Cardiac Troponins

Abstract

Objective: To evaluate the frequency of MVCAD in patients with NSTEMI and markedly raised cardiac troponins, and to assess the associated clinical outcomes and management strategies.

Methodology: A cross-sectional study was conducted from January 2021 to January 2022 at Department of Cardiology, Hayatabad Medical Complex Peshawar. A total of 135 NSTEMI patients with significantly elevated cardiac troponins were included. Comprehensive diagnostic evaluations, including coronary angiography, were performed to assess the presence and extent of MVCAD. Data on demographics, clinical characteristics, management strategies, and clinical outcomes were collected and analyzed.

Results: The mean age of the patients was 64.3 ± 10.2 years, with 60.7% being male. MVCAD was found in 65.9% of patients, with 27.4% having two-vessel disease and 38.5% having three-vessel disease. Patients with MVCAD demonstrated significantly higher rates of recurrent ischemic events (18.7%), heart failure (14.6%), and mortality (7.9%) compared to those with single-vessel disease. Among patients with MVCAD, 65.2% underwent PCI, 23.6% were managed with CABG, and 11.2% received optimal medical therapy.

Conclusion: The study highlights the high prevalence and clinical significance of MVCAD in NSTEMI patients with markedly raised cardiac troponins. These findings underscore the need for comprehensive diagnostic evaluations and aggressive therapeutic strategies to manage this high-risk group effectively. Incorporating these insights into clinical practice can improve outcomes and reduce the burden of coronary artery disease in these patients.

Keywords: , MVCAD, PCI, CABG, Cardiac Troponins