COMPARISON OF RIGHT CORONARY ARTERY AND LEFT CIRCUMFLEX RELATED ACUTE INFERIOR WALL MYOCARDIAL INFARCTION IN PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Abstract

Objective: To compare right coronary artery and left circumflex related acute inferior wall MI in terms of clinical characteristics, severity markers, complications and mortality.

Study Design: Descriptive cross sectional study.

Place and Duration of Study: This study was carried out at Armed Forces Institute of Cardiology Rawalpindi, from July 2015 to June 2016.

Material and Methods: All the patients presenting to AFIC Emergency department with a history of chest pain for less than 12 hours and diagnosed as acute inferior wall MI on ECG are included in the study.

Results: A total of 250 patients were included in the study. About 148 (59.2%) patients had Right Coronary Artery (RCA) as culprit artery lesion whereas 102 (41.1%) patients had left circumflex (LCX) as culprit artery. Cardiogenic shock was seen in 10 (6.8%) patients with RCA as culprit artery lesion and 23 (25.6%) patients with LCX as culprit artery lesion. Multivessel involvement was seen in 50 (33.8%) patients with RCA and 48 (47.1%) patients with LCX as culprit artery. Heart failurekillip class III and IV was seen in 8 (5.4%) patients with RCA and 10 (9.8%) patients with LCX as culprit artery lesion. Complete heart block was seen in 36 (24.1%) patients with RCA related acute inferior wall MI and 3 (2.9%) patients with LCX related acute inferior wall MI. In-hospital mortality was more prevalent and was seen in 9 (8.8%) patients with LCX as culprit artery and 4 (2.7%) patients with RCA as culprit artery.

Conclusion: This study shows that patients............