Key result
Among patients with acute coronary syndrome, 35.1% had an atypical presentation, which was independently predicted by female gender (OR 5.453) and involved arterial territory.
Why the study?
The clinical spectrum and heterogeneity of acute coronary syndrome presentations in patients admitted to a tertiary care cardiac unit were not well characterized.
Cross-Sectional (n=370)
No
Odds Ratio: 5.453 (95% CI 1.892–15.714)
p-value: p=0.002
Atypical presentations of ACS are frequently linked to NSTEMI or unstable angina, with female gender and specific arterial territories serving as independent predictors of non-classical symptoms.
Objective: To study the clinical spectrum of Acute Coronary Syndrome in patients presenting to Cardiac Unit of a tertiary care hospital. Study Design: Cross-Sectional Observational StudyPlace and Duration of Study: This study was conducted at the Department of Medicine, Combined Military Hospital, Abbottabad, Pakistan from October 2025 to March 2026. Methods: Patients of both genders age 20-70 years, admitted to CCU, diagnosed with ACS were included. The demographic information, clinical presentation, risk factors, electrocardiographic findings, coro-angiographyfindings and inferred arterial territory were noted. Data were stratified according to age, risk factors, and clinical spectrum of ACS and variables compared within sub-types and arterial territory involved. Results: Three hundred seventy patients diagnosed with ACS were included with median age of 51.00 (17.00) years including 221 (59.7%) male and 149 (40.3%) female patients. STEMI was most common ACS subtype in 226 (61.1%) patients, followed by NSTEMI in 100 (27.0%) and unstable angina in 44 (11.9%) patients. The left anterior descending (LAD) artery was most frequently involved territory in 174 (47.0%) patients. Conclusion: Typical presentation of ACS was associated with STEMI, chest pain, ST elevation and LAD involvement. However, atypical cases were linked to NSTEMI or USA, dyspnea, ST depression or LBBB on ECG and PDA or Multivessel involvement on coro-angiography.
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Khan et al. (2026) conducted a cross-sectional in Acute Coronary Syndrome (ACS) (n=370). Female gender vs. Male gender was evaluated on Atypical presentation of acute coronary syndrome (OR 5.453, 95% CI 1.892-15.714, p=0.002). Among patients with acute coronary syndrome, 35.1% had an atypical presentation, which was independently predicted by female gender (OR 5.453) and involved arterial territory.
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