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Between 1990 and 2020, these diseases are expected to increase by 120% for women and 137% for men in developing countries, compared with 30–60% in developed countries. 4 By 2010, 60% of the world’s heart disease is expected to occur in India. 5 Furthermore, South Asians have a high prevalence of risk factors, and have ischaemic heart disease at an earlier age than do people in developed countries. 6,7 Most data for patients with acute coronary syndromes are from several large registries 8-11 with data on demography, treatments, and outcomes of patients in middle-income and high-income countries. There are fewer studies done in India 12-14 so little is known about the demographic pattern and predictors of severe disease in ACS, particular with NSTEMI. The natural history of significant stenosis of the left main coronary artery (LMCA) without revascularization treatment is associated with elevated mortality in patients with stable coronary disease (50% at 3 years) 15 as well as those with acute coronary syndrome (ACS) (78.6% in patients with acute myocardial infarction [AMI] complicated by cardiogenic shock) 16 . Stenosis of the LMCA is more frequent in high-risk patients with NSTE-ACS517 ; hence, the possibility of predicting its presence is of maximum interest. The aim of this study, performed in patients with NSTE-ACS, no known history of ischemic heart disease, and classified as at high risk, was to analyze whether any of the clinical, electrocardiographic, or biochemical parameters we use to stratify risk in NSTE-ACS at hospital admittance is related with significant LMCA stenosis in the coronary angiography undertaken later in patients of costal Andhra Pradesh, India.

Predictors of left main coronary artery disease in high risk patients with ACS, first episode of Non ST segment elevation MI in India