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Demographic and clinical characteristics of acute coronary syndrome patients with single versus multivessel coronary occlusion

Gallagher, Maura (2023) Demographic and clinical characteristics of acute coronary syndrome patients with single versus multivessel coronary occlusion. Undergraduate Thesis, University of Pittsburgh. (Unpublished)

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Introduction: Research suggests that the severity of coronary artery disease correlates with outcomes in patients with acute coronary syndrome (ACS). It remains unknown how this severity correlates with the extent of coronary disease (single vs. multivessel) and whether the latter is driven by patient characteristics. This analysis aims to explore baseline clinical characteristics, severity of occlusion, and extent of coronary disease.
Methods: This was a secondary analysis of a prospective cohort study that enrolled chest pain patients transported by ambulance to an urban tertiary-care hospital. This analysis included ACS patients with either ST- or Non-ST-Segment Elevation (STE-ACS or NSTE-ACS) subtype, who had angiographic evidence of coronary occlusion (≥50% narrowing in at least one main coronary artery). An independent reviewer abstracted clinical data on location of the culprit vessel(s) and severity of coronary occlusion reports. In addition to defining single versus multivessel disease, patients were also classified based on the amount of culprit vessels (no culprit, single culprit, or multiple culprits) that were found on the angiogram. Single and multivessel groups were compared using Chi-Square and Independent Samples T-test for continuous variables at an alpha level of 0.05.
Results: Our sample included 449 confirmed ACS patients (mean age 65, 36% females, 20% Black, 54% with NSTE-ACS). Compared to those with single-vessel disease (n=188, 42%), those with multivessel disease (n=261, 58%) were older (66 vs. 62, p<0.001), and more likely to have hypertension (79% vs. 65%, p =0.001), diabetes mellitus (38% vs. 23%, p < 0.001), dyslipidemia (58% vs. 42% p =0.014), heart failure (18% vs. 11%, p < 0.001), preexisting CAD (60% vs. 41%, p<0.001), previous CABG (23% vs. 5%, p <0.001), and use insulin (22% vs. 12%, p<0.001). Multivessel disease patients were more likely to have multiple culprit vessels (89% vs. 11%, p=<0.001). Those with multiple culprit vessels were more likely to be NSTE-ACS patients than STE-ACS patients (56% vs. 44%, p=<0.001).
Conclusion: This work highlights those with multivessel disease are more likely to have preexisting comorbidities and multiple culprit vessels, and the latter are more likely to be NSTE-ACS patients than STE-ACS patients. These findings have important implications for screening and triage.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Gallagher, Mauramkg45@pitt.edumkg450009-0001-4918-2787
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorHelman, Stephaniesmh178@pitt.edusmh178
Committee CoChairAl-Zaiti, Salah Shafiqssa33@pitt.edussa33
Committee MemberScott, Paul Wesleypws5@pitt.edupws5
Committee MemberZegre-Hemsey,
Date: 23 April 2023
Date Type: Publication
Defense Date: 2 March 2023
Approval Date: 23 April 2023
Submission Date: 11 April 2023
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 37
Institution: University of Pittsburgh
Schools and Programs: David C. Frederick Honors College
School of Nursing > Nursing
Degree: BSN - Bachelor of Science in Nursing
Thesis Type: Undergraduate Thesis
Refereed: Yes
Uncontrolled Keywords: acute coronary syndrome; single-vessel disease; multi-vessel disease; ST elevation; Non-ST elevation
Date Deposited: 23 Apr 2023 19:09
Last Modified: 23 Apr 2023 19:09


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