Journal of Isfahan Medical School

Journal of Isfahan Medical School

Anatomic Distribution of Coronary Culprit Lesion and Five-Year Follow-Up for Major Adverse Cardiac Events (MACE) in Patients with Acute Coronary Syndrome

Document Type : Original Article (s)

Authors
Seyed Mohammad Hashemi 1
Alireza Firouzfar 2
Parisa Hajheidari 2
Ghasem Yadegarfar 3
Manizheh Danesh 3
Pouria Shoureshi 2
1 Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor, Department of Epidemiology and Biostatistics, School of Health And Heart Failure Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Abstract
Background: Rupture of an atherosclerotic plaque or endothelial erosion with superimposed thrombosis in coronary arteries are primary causes of acute coronary syndromes. This study aimed to evaluate the anatomic distribution of culprit lesions by coronary territories, also to find any association between long-term outcomes and culprit lesion location in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).Methods: Patients presented at the emergency room of a tertiary cardiac center with symptoms suggestive of ACS, possible candidates for elective coronary angiography (CAG), were enrolled and followed up every year for five years for major adverse cardiac events (MACEs).Findings: The subjects had a mean age of 60.6 ± 11.3 years, whom 74.4% were men. CAG revealed that among 98 lesions in coronary arteries, the left anterior descending (LAD) artery was the most common accused artery with frequency of 46%. Five-year follow-up results showed that 32.2% of patients experienced MACE which developed more in the LAD (38%) and then the right coronary artery (RCA) territories (27.6%) with no significant differences between other territories.Conclusion: Although we found no significant differences between MACEs scores in different groups of coronary territories, but cardiologists may be able to plan follow-ups by the primary lesion. According to our study, the most frequent MACE was repeated percutaneous coronary intervention (PCI), which showed the importance of intervention in early diagnose, follow-up and treatment. Further studies with higher sample sizes are needed to show the prognostic value of culprit lesion territory in patients with ACS.
Keywords
Acute Coronary Syndrome
Atherosclerosis
Coronary arteries
Angiography
Prognosis
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Journal of Isfahan Medical School
Volume 35, Issue 444 - Serial Number 444
July and August 2017
Pages 1074-1079

  • Receive Date 25 June 2017
  • Accept Date 06 April 2022