Authors : Aabishkar Subedi; Birendra Kumar Yadav; Sharmila Lamichhane; Shekhar Maan Shrestha; Reshma Dahal; Sunil Yadav; Animesh Dhungana; Manish Karki

Volume/Issue : Volume 9 - 2024, Issue 8 - August

Google Scholar : https://tinyurl.com/293v8zn4

Scribd : https://tinyurl.com/yjdtedyd

DOI : https://doi.org/10.38124/ijisrt/IJISRT24AUG1285

Abstract : Introduction ST-elevation myocardial infarction (STEMI) is a critical condition affecting many individuals worldwide, posing significant risks to patient health and outcomes. Different types of STEMI, such as anterior wall and inferior wall STEMI, can lead to varying in-hospital outcomes following percutaneous coronary intervention (PCI). Understanding these differences is crucial for improving patient care and treatment strategies. This study aimed to compare the in-hospital outcomes of anterior and inferior wall STEMI in patients undergoing PCI at a tertiary care center.  Methods This descriptive cross-sectional study included 70 patients who underwent PCI for either Anterior or inferior wall STEMI at Chitwan Medical College Teaching Hospital ( CMCTH) and were admitted to the Critical Care Unit (CCU) from February 5th 2021 to March 4th 2022. Anterior wall or inferior wall STEMI was diagnosed using a surface Electrocardiogram (ECG) and in-hospital outcomes were recorded using structured Proforma. Data was entered and analyzed with SPSS-26.  Results Among the 70 patients included in the study, the mean age was 64.50 ± 9.818 years. The majority (77.1%) of patients were male and 22.9% of the patients were female. Among the patients of anterior wall MI who underwent PCI, 11 patients (15.7%) had cardiogenic shock, 21 patients (30.0%) had AKI, 2 patients (2.9%) had CVA, and 2 patients (2.9%) had death.  Conclusion Patients with anterior wall STEMI following PCI had worse in-hospital outcomes compared to those with inferior wall STEMI.

Keywords : Anterior Wall STEMI, Inferior Wall STEMI, In- Hospital Outcomes, PCI.

References :

1. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). Vol. 138, Circulation. 2018. 618–651 p.  [PubMed | Full Text | DOI]
2. Maskey A, Sayami A, Pandey MR. Coronary artery disease: an emerging epidemic in Nepal. Nepal Hear J. 2003;2(2):2–6. [Full Text ]
3. Kennedy HL, Goldberg RJ, Szklo M, Tonascia JA. The prognosis of anterior myocardial infarction revisited: A community‐wide study. Clin Cardiol. 1979;2(6):455–60. [PubMed | Full Text | DOI ]
4. Stone PH, Raabe DS, Jaffe AS, Gustafson N, Muller JE, Turi ZG, Rutherford JD, Poole WK, Passamani E, Willerson JT, et al. Prognostic significance of location and type of myocardial infarction: independent adverse outcome associated with anterior location. J Am Coll Cardiol. 1988 Mar;11(3):453-63.[ PubMed | Full Text | DOI]
5. Thanavaro S, Kleiger RE, Province MA, Hubert JW, Miller JP, Krone RJ, Oliver GC. Effect of infarct location on the in-hospital prognosis of patients with first transmural myocardial infarction. Circulation. 1982 Oct;66(4):742-7.   [ PubMed | Full Text |DOI ]
6. Hands ME, Lloyd BL, Robinson JS, de Klerk N, Thompson PL. Prognostic significance of electrocardiographic site of infarction after correction for enzymatic size of infarction. Circulation. 1986 May;73(5):885-91.[ PubMed | Full Text | DOI ]
7. Gupta T, Weinreich M, Kolte D, Khera S, Villablanca PA, Bortnick AE, Wiley JM, Menegus MA, Kirtane AJ, Bhatt DL, Garcia MJ, Latib A, Weisz G. Comparison of Incidence and Outcomes of Cardiogenic Shock Complicating Posterior (Inferior) Versus Anterior ST-Elevation Myocardial Infarction. Am J Cardiol. 2020 Apr 1;125(7):1013-1019. [ PubMed | Full Text | DOI ]