Frequency and Predictors of Triple Vessel Coronary Artery Disease Among Patients Presenting with Non-ST-Segment Elevation Myocardial Infarction: A Cross-Sectional Study at a Tertiary Care Cardiac Center.

Abstract

Background: To determine the frequency of triple vessel coronary artery disease (TVCAD) among patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI) and to identify demographic and clinical factors associated with its occurrence.

Methodology: This analytical cross-sectional study was conducted in the Department of Cardiology, Hayatabad Medical Complex, Peshawar. A total of 166 patients aged 20–80 years diagnosed with NSTEMI were consecutively enrolled. All participants underwent coronary angiography to evaluate the extent of coronary artery involvement. TVCAD was defined as ≥70% stenosis in all three major epicardial coronary arteries, namely the left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA). Demographic characteristics, cardiovascular risk factors, and angiographic findings were recorded using a structured proforma.

Results: The mean age of the participants was 56.69 ± 13.79 years, and the mean body mass index was 28.32 ± 2.86 kg/m². Males constituted 65.1% of the study population, while 54.2% were residents of rural areas. Triple vessel coronary artery disease was identified in 58 patients, corresponding to a frequency of 34.9%. Univariate analysis demonstrated significant associations between TVCAD and male gender (46.3% vs. 13.8%, p<0.001), rural residence (46.7% vs. 21.1%, p<0.001), low socioeconomic status (p<0.001), and smoking (60.0% vs. 25.6%, p<0.001). Following multivariable adjustment, male gender (adjusted odds ratio [aOR] 4.82; 95% CI: 2.10–11.05; p<0.001) and smoking (aOR 4.15; 95% CI: 1.98–8.69; p<0.001) remained independent predictors of TVCAD. No significant associations were observed with age, body mass index, hypertension, diabetes mellitus, dyslipidemia, or chronic kidney disease.

Conclusion: Approximately one-third of patients presenting with NSTEMI had angiographically confirmed triple vessel coronary artery disease. Male gender and smoking emerged as independent predictors of extensive coronary involvement.