FREQUENCY OF MULTIVESSEL CORONARY ARTERY DISEASE IN PATIENT WITH INFERIOR WALL MYOCARDIAL INFARCTION AT FIRST PRESENTATION

Abstract

Background: Inferior wall myocardial infarction (IWMI) is traditionally considered to have a better prognosis than other myocardial infarction types. However, emerging evidence suggests that a significant proportion of these patients may have underlying multivessel coronary artery disease (MVD), which can adversely affect outcomes and necessitate more aggressive management.

Objective: To determine the frequency of multivessel coronary artery disease in patients presenting with inferior wall myocardial infarction.

Methods: A cross-sectional study was conducted at the National Institute of Cardiovascular Diseases (NICVD), Karachi, over a period of six months. A total of 170 patients aged 18–65 years with confirmed IWMI within four hours of symptom onset and undergoing coronary angiography were enrolled through non-probability consecutive sampling. Patients with prior MI, PCI, CABG, renal or liver disease, and arrhythmias were excluded. Demographic, clinical, and angiographic data were collected. Data were analyzed using SPSS v24, with frequencies, means, and chi-square tests applied where appropriate.

Results: Among 170 patients, 71.8% were male and the mean age was 54.2 ± 8.6 years. Multivessel disease was found in 63.5% of patients, with triple-vessel disease seen in 35.3% and double-vessel disease in 28.2%. The right coronary artery (RCA) was the most frequently involved infarct-related artery (76.5%). Hypertension, diabetes, and smoking were common risk factors. Patients with multivessel disease had a higher frequency of these comorbidities.

Conclusion: A substantial proportion of patients presenting with IWMI had multivessel coronary artery disease. These findings highlight the importance of early angiographic assessment and comprehensive risk evaluation to optimize treatment strategies.