Frequency of Multivessel Severe Coronary Artery Disease in Patients With Non-ST Segment Elevation Myocardial Infarction Having Markedly Raised Cardiac Troponin T.
acute coronary syndrome (acs)
multivessel coronary artery disease (mvcad)
myocardial infarction (mi)
non-st segment elevation myocardial infarction (nstemi)
st segment elevation myocardial infarction (stemi)
troponin t
unstable angina
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
05 Aug 2020
05 Aug 2020
Historique:
entrez:
11
9
2020
pubmed:
12
9
2020
medline:
12
9
2020
Statut:
epublish
Résumé
Introduction Non-ST segment elevation myocardial infarction (NSTEMI) is becoming more common than ST segment elevation myocardial infarction (STEMI) and data regarding presence of underlying multivessel coronary artery disease (MVCAD) in these patients is consistent in locoregional population that leads to lethal delays in proper management. Therefore, in the current study, we aimed to evaluate the frequency of MVCAD in NSTEMI with markedly raised troponin T levels. This will help to identify patients that should be labeled as high risk and must be referred for coronary revascularization on priority basis, so that clinical outcomes can be improved in these patients. Methods This cross-sectional research study was carried out at Chaudhary Pervaiz Elahi Institute of Cardiology, Multan over a period of one year. A total of 326 patients with history of chest discomfort within past 48 hours of presentation or angina equivalent symptoms and cardiac troponin T more than 500 ng/l were included in the study. Coronary angiography was done within 72 hours of same hospital admission. The outcome variable i.e. MVCAD was determined. Results Mean age of patients was 50.74 ± 7.75 years with range of 30 to 60 years. MVCAD was found in 107 (32.82%) patients, whilst there was no MVCAD in 219 (67.18%) patients. Moreover, no significant association of MVCAD was noted with age or smoking. Conclusion We found presence of MVCAD in a considerable number of patients presenting with NSTEMI. The key to detect the underlying presence of MVCAD in these patients is lifted troponin T levels. Therefore, we conclude that any patient with elevated troponin T levels, even in the absence of ST segment elevation, should undergo cardiac catheterization to detect presence of MVCAD as this subset of patients can benefit from early revascularization including coronary artery bypass graft (CABG) surgery.
Identifiants
pubmed: 32913688
doi: 10.7759/cureus.9571
pmc: PMC7474558
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e9571Informations de copyright
Copyright © 2020, Hashmi et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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