Clinical and Angiographic Profile of Acute Coronary Syndrome Patients Undergoing Coronary Angiography at the Kashmir Institute of Cardiology.

Abstract

Background: Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Acute coronary syndrome (ACS), including ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina, represents the most severe manifestation of CAD. Coronary angiography is the gold standard for diagnosing CAD and assessing the extent of coronary involvement. This study aimed to evaluate the demographic characteristics, cardiovascular risk factors, clinical presentation, and angiographic patterns of CAD among patients with ACS undergoing coronary angiography at the Kashmir Institute of Cardiology.

Methodology: A single-center cross-sectional observational study was conducted at the Kashmir Institute of Cardiology, Mirpur, Azad Jammu and Kashmir, Pakistan, from June to October 2025. A total of 100 patients aged >18 years presenting with ACS and undergoing coronary angiography were included using consecutive sampling. Demographic characteristics, clinical presentation, cardiovascular risk factors, and angiographic findings were recorded using a structured data collection form. Significant CAD was defined as ≥50% luminal stenosis in a major epicardial coronary artery.

Results: Among the 100 patients, 65% were male, with a mean age of 58 years. Most patients were aged 40–60 years (62%). STEMI was the most common clinical presentation (67%), followed by NSTEMI (19%) and unstable angina (14%). The most prevalent cardiovascular risk factors were diabetes mellitus (76%) and hypertension (74%), followed by smoking (31%), dyslipidemia (7%), and family history of CAD (2%). Coronary angiography showed that double-vessel disease was the most common finding (35%), followed by single-vessel disease (31%) and triple-vessel disease (22%). The left anterior descending artery was the most frequently involved coronary artery.

Conclusion: There is a high prevalence of modifiable cardiovascular risk factors and a predominance of multi-vessel coronary artery disease among patients presenting with ACS. These findings highlight the importance of early detection and effective management of cardiovascular risk factors to reduce the burden of CAD.