Background: Wellens syndrome is an electrocardiographic marker of critical proximal left anterior descending (LAD) artery stenosis and a strong predictor of anterior wall myocardial infarction if left untreated. Objective: To determine the frequency of left ventricular systolic dysfunction in patients with Wellens syndrome undergoing coronary angiography. Methods: This descriptive cross-sectional study was conducted at the in-patient department of the National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan, from March 2025 to 10 June 2025. A total of 187 patients were included using non-probability consecutive sampling. Patients aged 18–60 years of both genders undergoing coronary catheterization were enrolled, excluding those with previously established LVSD. Results: The mean age of the study population was 51.3 ± 7.8 years, with 110 (58.8%) males and 77 (41.2%) females. Diabetes mellitus was present in 92 (49.2%) patients, hypertension in 101 (54.0%), and smoking history in 77 (41.2%). Angiography revealed proximal LAD lesions in 164 (87.7%) patients. LVSD was observed in 111 patients, giving a frequency of 59.4%. Among these, mild LVSD was present in 48 (25.7%), moderate in 39 (20.9%), and severe in 24 (12.8%). LVSD was significantly more frequent in patients with diabetes (68.5% vs. 50.0%, p = 0.01), hypertension (65.3% vs. 52.3%, p = 0.04), and triple-vessel disease (77.8%, p < 0.001). Conclusion: A high frequency of left ventricular systolic dysfunction was observed in patients with Wellens syndrome undergoing angiography, particularly in those with diabetes, hypertension, and multivessel disease.
Anees et al. (Tue,) studied this question.