Pattern of Coronary Disease Burden in Patients With STEMI Versus Other ACS Modalities i.e., NSTEMI and Unstable Angina
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Background: Acute coronary syndrome (ACS) includes ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina. Coronary angiography helps define the anatomical burden of disease and supports clinical decision-making. Objective: To determine the pattern of coronary disease burden among patients presenting with STEMI and other ACS modalities, including NSTEMI and unstable angina. Methods: This descriptive cross-sectional study was conducted in the Department of Cardiology, Bolan Medical College/Hospital, Quetta, from March 5, 2024, to November 19, 2024. A total of 145 patients with ACS underwent clinical assessment and coronary angiography. Data were analyzed using SPSS version 23.0. Continuous variables were reported as mean ± standard deviation, while categorical variables were reported as frequencies and percentages. Results: The mean age was 56.08 ± 5.41 years, mean body mass index was 26.94 ± 1.58 kg/m², and mean symptom duration was 5.11 ± 1.72 hours. STEMI was the most frequent presentation, observed in 84 patients (57.9%), followed by unstable angina in 43 (29.7%) and NSTEMI in 18 (12.4%). Double-vessel disease was the most common angiographic pattern, seen in 68 patients (46.9%), followed by single-vessel disease in 28 (19.3%), multiple-vessel disease in 23 (15.9%), triple-vessel disease in 22 (15.2%), and left main coronary disease in 4 (2.8%). Conclusion: STEMI was the most common ACS presentation, and double-vessel disease was the predominant angiographic pattern. The findings indicate a substantial burden of coronary involvement beyond isolated single-vessel disease among ACS patients.
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