Comparison Between Angiographic Findings Of Coronary Artery Disease In Stemi And Nstemi Patients

Abstract

Background: Acute coronary syndrome (ACS) is a life-threatening cardiac event including two different types of events, ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), which have significant differences in their pathophysiology and angiographic profile as well as clinical management. STEMI is typically associated with an acute total occlusion of a single vessel, whereas NSTEMI generally presents with more diffuse, multivessel coronary artery disease. Both have unique presentations, but both are associated with significant morbidity and mortality. A detailed understanding of angiographic differences is crucial for risk stratification and choice of the invasive revascularization technique.

Objectives: To evaluate angiographic differences of coronary artery disease in STEMI compared to NSTEMI patients including vessels involved, location and morphology of lesions collateral circulation curriculum vitae-2445 that is reflected in the article titled "Assessing Malignancies Among Men Psycho Oncology" at PIC Lahore.

Methods: Cross-sectional study conducted at PIC, Lahore for a duration of 04 months. Through convenient sampling, data were collected from a total of 50 patients (25 STEMI, 25 NSTEMI) with confirmed diagnosis of acute myocardial infarction. Step 1: The diagnosis was based on clinical presentation, ECG changes and cardiac biomarkers. Patients were excluded if they underwent CABG prior to PCI, had sustained non-ischemic myocardial injury from other causes or incomplete angiographic data. Diseased vessel count, artery involved, lesion type, collateral circulation and TIMI flow were captured in the study. Methods: Data were analyzed using SPSS v. 25, with categorical variables reported as frequencies and percentages.

Results: 78% of patients were males and 90% aged 41–80 years. There were multiple cardiovascular risk factors in 62% of cases. Involvement of the right coronary artery (48%) was most common, followed by the left anterior descending artery (42%). The commonest ECG finding was inferior myocardial infarction (54%). 46% of cases were distal lesions, with complex, diffuse and calcified morphologies accounting for one-third each. 53% of patients had poor initial coronary perfusion (TIMI 0–1). Patients with NSTEMI had a markedly greater multivessel and diffuse disease, while patients with STEMI more often presented as an acute single-vessel occlusion.

Conclusion: Coronary angiography effectively differentiates STEMI and NSTEMI based on disease distribution and severity. STEMI is predominantly characterized by acute single-vessel occlusion, while NSTEMI presents with more complex, multivessel atherosclerotic burden. Both entities require early angiographic evaluation to guide timely revascularization and improve patient outcomes.