ABSTRACT

Non-ST-segment elevation myocardial infarction (NSTEMI) is more communal than ST-segment elevation myocardial infarction (STEMI), and statistics on the coexistence of severe coronary disease among these individuals is consistent across the populace results in fatal postponement in appropriate treatment.

      So, in this study, we tried to assess the incidence of severe coronary artery disease in NSTEMI where serum levels of troponin I  are significantly elevated. This will benefit to recognize people who must be categorized as high-risk and refer them to priority centers for coronary revascularization so that the clinical outcomes in these patients can be improved.

Study Design: A cross-sectional study.

Methods: A total of 118 patients with a history of chest complaints for the last 48-hours or symptoms equivalent to angina. After 72 hours of admission; Coronary angiography was performed in the same hospital. The result variable; severe coronary artery disease was labeled.

Results: Of 118 patients, 106 (89.8%) were females, 12 (10.2%) were males, and the M:F ratio was 8.8: 1. 56.05 ± 4.21 years was the mean age of the patients and 30 to 60 years was the age range. Most of the subjects were 51 and 60 years of age (98=83.1%).  In this analysis, 16 (13.6%) patients had severe CAD, while 102 (86.4%) patients did not have. The mean Troponin-I level was 7.65±3.07. One vessel was involved in 35(29.7%) of patients, two vessels were involved in 63(53.4%) of patients and three vessels were involved in 20(16.9%) of patients.

Conclusions: We institute severe coronary artery disease among significant number of NSTEMI patients. High troponin I levels are key to detecting the occurrence of severe coronary artery disease among these patients. Therefore, we concluded that cardiac catheterization should be performed to detect its presence in all patients with trop-T elevation, even without ST elevation so that the patients may get advantage from prompt revascularization, counting coronary artery bypass graft (CABG) surgery. The severity of coronary artery disease was found in 13.6% of patients with raised cardiac troponin levels.

Keywords: ST-segment elevation myocardial infarction (STEMI), non-ST segment elevation acute coronary syndrome (ACS).