Patterns of Coronary Artery Occlusion in Acute Coronary Syndrome Patients Undergoing Coronary Angiography in a Cardiac Center of a Low-Middle Income Country

Abstract

Objectives: This study aims to identify and describe the patterns of coronary artery occlusion in patients with acute coronary syndrome (ACS) undergoing coronary angiography, with a particular focus on the association of traditional cardiovascular risk factors with disease severity. Methodology: This descriptive, cross-sectional study included 174 ACS patients who underwent coronary angiography between December 30, 2020, and June 30, 2021, at Hayatabad Medical Complex. Patient demographics, clinical presentations, and angiographic findings were systematically analyzed. Statistical analysis, including chi-square tests, was performed to explore associations, with significance set at p<0.05. Results: The mean age of the study population was 57.4 years, with 70.1% male and 29.9% female participants. Single vessel disease (SVD) was the most common coronary artery pattern, present in 43.7% of patients, followed by double vessel disease (DVD) in 33.3% and triple vessel disease (TVD) in 23.0%. The left anterior descending (LAD) artery was most frequently involved, accounting for 58.6% of cases, followed by the right coronary artery (RCA) in 35.1% and the left circumflex artery (LCx) in 25.9%. Significant associations were found between traditional cardiovascular risk factors—hypertension, diabetes, and smoking—and more severe disease, highlighting their role in disease progression. Conclusion: Single vessel disease, particularly involving the LAD artery, emerged as the predominant pattern of coronary occlusion among ACS patients in this study. The strong association of hypertension, diabetes, and smoking with increased disease severity underscores the importance of early and targeted interventions, such as blood pressure control, smoking cessation, and diabetes management, to improve clinical outcomes and reduce the burden of coronary artery disease.