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Clinical and Angiographic Profile of Acute Coronary Syndrome: Insights From a Tertiary Care Center in an Industrial Area

Year: 2025

Type: article

Abstract: Background Acute coronary syndrome (ACS) patterns may be modified by environmental factors in industrial regions. This study examines the clinical and angiographic profile of ACS patients in a polluted industrial area of Eastern India. Methods We analyzed 213 consecutive ACS patients undergoing coronary angiography at a tertiary care center (April 2024-March 2025). Using RStudio, we performed descriptive statistics, comparative analyses (t-tests/Mann-Whitney U test for continuous variables; chi-square/Fisher's exact test for categorical variables), and multivariable logistic regression adjusting for age, sex, and hypertension. Effect sizes were calculated as odds ratios (OR) with 95% confidence intervals. Results The cohort (median age 58 years; 64.8% male) showed a high prevalence of dyslipidemia (119; 55.9%) and hypertension (103; 48.4%), with non-ST-elevation myocardial infarction (NSTEMI) being the most common presentation (86; 40.4%). Angiography revealed obstructive coronary artery disease (CAD) in 170 (79.8%) (predominantly LAD involvement: 85), non-obstructive CAD in 43 (20.2%), and slow-flow phenomenon in 61 (28.6%). Notably, spontaneous coronary artery dissection (SCAD) cases (11; 5.2%) showed an atypical 1:1 sex ratio. Patients with obstructive CAD were significantly older (median 62 vs 44 years, p<0.001) and demonstrated a paradoxical inverse association with diabetes (unadjusted OR 7.5, 95% CI 3.6-15.7, p<0.001). Conclusion This industrial cohort exhibited distinct ACS patterns, including high rates of microvascular dysfunction and atypical SCAD epidemiology, suggesting potential environmental influences on coronary pathophysiology that warrant further investigation.

Source: Cureus

DOI: 10.7759/cureus.83805

Authors: Anindya Banerjee, Ishita Majumdar, Madhurima Ganguly, Mohammed I Hussain, Debasish Das

Institutions: Institute of Post Graduate Medical Education and Research, All India Institute of Medical Sciences Bhubaneswar

Language: English

Topic: Acute Myocardial Infarction Research

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4410224618