Abstract

Background: Non-ST elevation myocardial infarction (NSTEMI) presents a significant clinical challenge, particularly in the context of multi-vessel disease (MVD), which complicates patient management and impacts prognosis. The variability in short-term outcomes following percutaneous coronary intervention (PCI) for NSTEMI patients with MVD necessitates a deeper understanding of the associated risk factors and outcomes.
Objective: To evaluate the risk factors and short-term clinical outcomes of NSTEMI patients after multi-vessel PCI, identifying predictors of major adverse cardiovascular events (MACE) and cardiac death within this population.
Methods: This retrospective study was conducted at Lady Reading Hospital, Peshawar, from January 2022 to December 2022, including 100 NSTEMI patients who underwent multi-vessel PCI. The Institute Review Board approved the study, adhering to the Declaration of Helsinki. Data on demographics, clinical characteristics, and outcomes were collected. Multi-vessel disease was defined by ≥50% narrowing in the left main coronary artery or ≥70% in at least two major epicardial coronary arteries. Statistical analysis employed SPSS Version 25.0, with Kaplan–Meier and Cox regression analyses determining the impact of various predictors on short-term outcomes.
Results: The mean age of participants was 65.6 ± 10.5 years, with a BMI of 22.75 ± 4.67 kg/m^2. Diabetic and ischemic heart disease prevalence was 30.4% and 26.9%, respectively. Multi-vessel disease was observed in 66.2% of patients. Short-term mortality and MACE rates were significantly influenced by factors such as age, lower BMI, renal dysfunction, and left ventricular dysfunction. The cumulative incidence of MACE within 30 days post-PCI was notably higher in patients with these risk factors.
Conclusion: NSTEMI patients undergoing multi-vessel PCI face a significant risk of short-term adverse outcomes. Key predictors of increased risk include advanced age, diabetes, ischemic heart disease, and renal dysfunction. Tailored management strategies focusing on these high-risk groups are essential for improving short-term prognosis.