NON-OBSTRUCTIVE CORONARIES IN PATIENTS PRESENTING WITH THE NON ST-ELEVATION ACUTE CORONARY SYNDROME

Authors

  • Shakir Zada National Institute of Cardiovascular Diseases (NICVD), Karachi https://orcid.org/0009-0006-3047-3142
  • Khalid Iqbal Bhatti National Institute of Cardiovascular Diseases, Karachi
  • Muhammad Zeb National Institute of Cardiovascular Diseases, Karachi https://orcid.org/0009-0005-8225-8666
  • Romana Pirah National Institute of Cardiovascular Diseases, Karachi
  • Daniyal Musaddiq National Institute of Cardiovascular Diseases, Karachi
  • Aziz ur Rehman Memon National Institute of Cardiovascular Diseases, Karachi https://orcid.org/0009-0009-7526-0417

DOI:

https://doi.org/10.55519/JAMC-03-12028

Keywords:

Acute Coronary Syndrome, CAB, Non-Obstructive Coronaries, NSTEMI, PCI

Abstract

Background: Worldwide, cardiovascular diseases are the major cause of mortality and morbidity with acute coronary syndrome as the most common clinical manifestation. In a typical clinical setup, around 30% of the patients presented with “ST-segment elevation myocardial infarction (STEMI)” caused by the complete occlusion of the coronary artery and the remaining 70% with intermittent or partial occlusion of the coronary termed as non-ST elevation The aim of this study was to assess the prevalence and characteristics of non-obstructive coronary arteries among patients presenting with non ST-elevation acute coronary syndrome (NSTE-ACS) at a tertiary care cardiac center of Karachi, Pakistan. Methods: This was a descriptive cross-sectional study, conducted at a tertiary care hospital in Karachi. Study inclusion criteria were patients of either gender admitted with NSTE-ACS and age between 30-70 years. A routine coronary angiogram was performed in all the patients and the absence of ≥50% stenosis in any major epicardial vessel was taken in non-obstructive coronaries. Results: A total of 174 patients (30–70 years) were included, of which 99 (56.9%) were male and the mean age was 59.43±11.24 years. In the distribution of socioeconomic status, 54 (31.0%) were lower class, middle class 81 (46.6%) while upper-class status were 39 (22.4%). Hypertension was observed in 76 (43.7%), chronic kidney disease in 20 (11.5%), and hyperlipidemia in 55 (31.6%). Non-obstructive coronary arteries were noted in 25 (14.4%) patients. Conclusion: It is to be concluded that non-obstructive coronary arteries are fairly prevalent in patients arriving in hospital with NSTE-ACS in our population. Further research is needed to better understand the underlying pathophysiology and optimal management strategies for patients with NOCA in the setting of NSTEMI.

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Additional Files

Published

2023-07-09