Culprit Lesion Location in ST Elevation Myocardial Infarction: Association with Risk Factors and Left Ventricular Ejection Fraction

Context: ST-elevation myocardial infarction (STEMI) is a critical manifestation of coronary artery disease characterized by sudden and complete occlusion of a coronary artery. The location of the occlusion significantly affects the patient’s prognosis. Aims: This study aims to assess the location of lesions in STEMI patients and their association with underlying risk factors. Settings and Design: This prospective observational study was conducted from July 2021 to November 2023. Subjects and Methods: Patients of both sexes, over 18, with STEMI who underwent primary percutaneous coronary intervention (PCI) or PCI within 24 h after fibrinolytic therapy were included in the study. The patients’ angiographic data were reviewed, and the locations of the culprit lesions were classified as proximal or nonproximal. Statistical Analysis Used: The Student’s t -test or Mann–Whitney U -test and one-way ANOVA or Kruskal–Wallis were used for comparisons by SPSS. Statistical significance was considered P < 0.05. Results: There were 212 patients for analysis. Of 212 patients (25–86 years, 88.7% male), 40.1% had proximal lesions with a lower left ventricular ejection fraction (LVEF) compared to nonproximal lesions (35.5 [31.88–45] vs. 45 [40–50], P < 0.001). Diabetes mellitus (DM), hypertension, and smoking histories were present in 19.9%, 36.2%, and 49.0%, respectively. There was no significant difference in proximal versus nonproximal culprit lesions according to risk factors. Conclusions: Patients diagnosed with STEMI and proximal coronary lesions have lower LVEF compared to those with nonproximal lesions. There was no significant association between culprit lesion location and risk factors, including sex, hypertension, DM, dyslipidemia, body mass index, smoking, and age.