IN-HOSPITAL MORTALITY AFTER INCOMPLETE PERCUTANEOUS REVASCULARIZATION IN PATIENTS WITH MULTIVESSEL CORONARY ARTERY DISEASE PRESENTING WITH ACUTE CORONARY SYNDROME

Abstract

Objectives: Patients with significant multi-vessel coronary artery disease (CAD) are approximately one-half to two-thirds of patients presenting with acute coronary syndrome (ACS). Therefore, this study aimed to evaluate the in-hospital mortality of incomplete percutaneous revascularization in a patient with multi-vessel CAD presenting with ACS at a single tertiary care hospital in Karachi, Pakistan.

Methodology: This descriptive study with 282 included consecutive patients from March 22, 2021, to September 21, 2021, fulfilling the inclusion criteria of aged between 18 and 75 years and of any gender, diagnosed with ACS, multi-vessel diseases, and undergone percutaneous revascularization of culprit artery only. Patients with pre-existing chronic kidney disease or cardiogenic shock at presentation were excluded. All patients were kept under observation during the hospital stay for up to one week, and in-hospital mortality was recorded.

Results: Mean age was 55.7±10.8 years with 185 (65.6%) male patients. Types of ACS were noted as ST-elevation myocardial infarction (STEMI) in 109 (38.7%), 117 (41.5%) non-STEMI, while unstable angina was noted in 56 (19.9%) patients. Three-vessel disease was noted in 126 (44.7%), 108 (38.3%) were diabetics, 164 (58.2%) were hypertensive, and 128 (45.4%) were smokers. In-hospital mortality was documented in 22 (7.8%) patients.

Conclusion: A significant proportion of in-hospital mortality was observed after incomplete percutaneous revascularization in ACS patients with multi-vessel CAD.