A Study of angiographic profile of patients with acute myocardial infarction, thrombolysed vs non thrombolysed and correlation with lipoprotein (a)

Amongst the males, STEMI was the most common presentation whereas among females, most patients, (53.3%) had NSTEMI (p value -0.01).The mean age of patients with STEMI was 56. ± 1.0 years, NSTEMI was 61. ± 5.4 years and UA was 59. ± 1.5 years with no significant difference between the three.All three types of ACS were more common in 55-75 years age group.Most common risk factors for CAD among the cases was smoking (59.2%), followed by a positive family history (50.0%), hypertension (40.8%) and diabetes (39.5%).Troponin levels were found to be positive in 80.3% patients, i.e.STEMI and NSTEMI.The mean duration of stay for cases was 4. ± .4 days with was no significant difference between patients with STEMI, NSTEMI and UA (pvalue of 0.81).The mean duration of symptoms of patients was 4. ± .6 hours.There was no significant difference between the ACS subgroups (p ¼ 0.324).The mean LVEF of ACS patients was 46. ± .7% with a statistically significant difference between STEMI and UA (p-value -0.01) and NSTEMI and UA (p-value 0.03).Dominant modality of treatment in ACS was PCI (56 patients), 1 patient underwent CABG, 6 patients received thrombolytic treatment (1 by intracoronary route during PCI) out of which 3 underwent Rescue PCI. 4 (7.1%)patients needed TPI support and 5 (8.9%) patients needed IABP support.17 patients were put on medical treatment which included 7 patients who had refused either CABG or PCI and those found to have mild coronary artery disease or recanalized vessels.3 patients succumbed to death e 2 in NSTEMI group out of which 1 had undergone PCI and 1 in the STEMI group who had also undergone PCI.88.1% of 76 ACS patients were discharged successfully Most patients had SVD (61.8%), 19.7% patients had DVD, 11.8% patients had TVD and 6.6% patients had mild CAD.There was no statistically significant difference between the four groups with respect to the type of ACS (p ¼ 0.14).The mean Gensini score of ACS patients was found to be 45.± 3.8 with no significant difference between males and females (p-value-0.38).19.7% cases had a Gensini Score less than 20 (Mild CAD) with a mean score of 11. ± .3 whereas 80.3% cases had a Gensini Score more than 20 (Severe CAD) with a mean of 54. ± 2.6.The mean Gensini score of STEMI, NSTEMI and UA patients was 50.± 0.2, 54. ± 7.0 and 23. ± 8.1 respectively.Severe CAD i.e.Gensini Score > 20 was seen in 68.9% patients with STEMI, 80% patients with NSTEMI and 46.7% patients with UA with a statistically significant difference (p-value -0.00).Conclusion: Early screening of risk factors and prompt management can go a long way in reducing the morbidity and mortality of ACS. ABN0022