Cardiovascular Risk Factors in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction and their Association with Left Anterior Descending Artery Involvement & Triple Vessel Disease


Objective: To determine the frequency of cardiovascular risk factors in patients presenting for primary percutaneous coronary intervention (P-PCI) and evaluate their association with left anterior descending artery involvement and triple vessel disease.

Methodology: This descriptive cross-sectional study was done at the Rawalpindi Institute of Cardiology, Rawalpindi from March 2019 to January 2021 after approval from the ethical review board. A total of 3000 patients with ST-elevation myocardial infarction (STEMI), who underwent P-PCI were enrolled by non-probability convenient sampling. The patient information including age, gender, predominant vessel, number of vessels involved, smoking status, left ventricular ejection fraction (LVEF), and history of diabetes mellitus and hypertension was noted on a proforma. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 25.

Results: Diabetes mellitus, hypertension, and smoking were present in 897(29.9%), 1216(40.5%) and 990(33%) of the patients, respectively. The left anterior descending artery (LAD) was involved in most of the cases (56.2%) followed by the right coronary artery (33.7%) while left circumflex was involved in 10.1% of the cases. Single vessel disease was present in 55.7% and triple vessel disease (TVD) in 15.8% of the patients. Left anterior descending artery involvement was associated with age, gender, LVEF, triple vessel disease and type of disease. However, there was no significant association found between the involvement of LAD and the occurrence of risk factors such as smoking, HTN, and DM. Triple vessel disease was associated with age, LVEF, predominance of vessel and hypertension.

Conclusion: Risk factors such as diabetes, hypertension, and smoking are more common in patients presenting for P-PCI as compared to the general population. Triple vessel disease is associated with age, left ventricular ejection fraction (LVEF), the predominance of the vessel, and hypertension. Left anterior descending artery involvement is associated with age, gender, LVEF, triple vessel disease, and type of disease.

By Muhammad Mohsin, et al.

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