Coronary artery dominance in cases with IWMI

Background: Acute coronary syndrome is one of the most common life-threatening emergency and one of the leading causes of sudden death. If diagnosed in time, the patient can be saved. Angiography is the gold standard and helps in identifying the affected vessel. Aims and objective: To see the frequency of coronary artery dominance in cases presenting with inferior wall myocardial infarction. Material and Methods: This cross sectional observational study was done in the emergency department of Punjab Institute of Cardiology, Lahore from March to August 2017. All the patients between 18-60 years of age, both genders, diagnosed with IWMI and had been given thrombolytic therapy within 24 hours of MI were included in this study. Those patients having history of heart failure as determined by the past medical record, patients with renal failure (serum creatinine on admission 1.1 mg/dL), patients with a history of rheumatic heart disease, hypertension 5 years, uncontrolled diabetes (determined by HbA1C 7%), patients having history of previous myocardial infarction or concomitant involvement of other coronary artery areas like an anterior wall or septal wall and those were excluded from this study who did not give informed consent. Results:  227 patients enrolled in this study. Mean age of the patients was 45.07±8.17 years. Males were 51.98% (n=118) and females were 48.02% (n=109) of our study population. Mean BMI was 26.13 ± 3.29. The dominant left circumflex artery (LCX) was found in 25.55% of subjects Right Coronary Artery (RCA) was found to be dominant in 74.45% of our subjects. Conclusion: Presentation of IWMI with RCA as the dominant artery is three times more common as compared to LCx in our local population.