Comparison of routinely used biochemical markers in the emergency department in cases of acute myocardial infarction associated with one or more vessels

Introduction and Objective: Acute myocardial infarction (AMI), one of the leading causes of death worldwide, is of paramount importance. It is crucial for patients presenting with chest pain to receive a prompt diagnosis and initiate treatment. Assessing the relationship between acute myocardial infarction (AMI) and the number of affected vessels is important for understanding the prevalence of the disease and developing treatment strategies. Studies have shown that patients with single-vessel coronary artery disease, especially those with non-infarct myocardial infarction, have a higher prevalence and lower troponin values. Therefore, comparing the performance of biochemical markers in cases of acute myocardial infarction (AMI) with one or more affected vessels is of great value for evaluating clinical outcomes. Materials and Methods: The study included patients aged 18 and over who presented to the emergency department of Bezmialem Vakif University between January 2022 and December 2022, received a diagnosis of acute myocardial infarction (AMI), and then underwent coronary angiography at the same center, where stenosis of 50% or more was detected in one or more coronary arteries. Data obtained from retrospective analysis and electronic information management system were recorded for 171 patients. Patients were divided into two groups, one with acute myocardial infarction (AMI) associated with one or more vessels, and the data obtained from these two groups were compared. SPSS (Statistical Package for the Social Sciences, Chicago, IL, USA) version 21.0 was used for the statistical analysis of all data, and the statistical significance level was set at p <0.05. Results: A total of 171 patients who were diagnosed with AMI after presenting to the emergency department and undergoing coronary angiography in our hospital, where stenosis of 50% or more was detected in one or more coronary arteries, were included in the study. The mean age of the patients was calculated as 60.4±12. Of the patients, 125 (73.1%) were male and 46 (26.9%) were female. It was found that 50 (29.2%) of the patients had no diagnosis of any chronic disease, 11 (6.4%) had DM, 37 (21.6%) had HT, and 67 (39.2%) had more than one chronic disease diagnosis. According to the examined coronary angiography results, it was determined that 31 (18.1%) of the participants had RCA, 40 (23.4%) had LAD, 22 (12.9%) had CX, 2 (1.2%) had LMCA, 16 (9.4%) had RCA and LAD, 12 (7%) had RCA and CX, 1 (0.6%) had RCA and LMCA, 16 (9.4%) had LAD and CX, 30 (17.5%) had RCA, LAD, and CX, and 1 (0.6%) had RCA, LAD, CX, and LMCA occluded. It was calculated that 95 (55.6%) of the participants had occlusion of a single vessel, and 76 (44.4%) had occlusion of more than one vessel. When the participants were evaluated according to the number of occluded vessels, it was determined that there was a statistically significant difference in LDL/HDL values (p=0.025). When the participants were evaluated according to the number of occluded vessels, it was determined that there was no statistically significant difference in age, gender, chronic disease, smoking, diagnosis, hemoglobin, neutrophil/lymphocyte, AST, troponin, CK-MB, triglyceride, creatinine, HDL, and LDL values. Conclusion: In our study, where we examined the relationship between acute myocardial infarction (AMI) and biochemical markers routinely used in the emergency department, we concluded that high LDL/HDL ratio was associated with AMI involving more than one vessel. No other statistically significant result was reached when the examined biochemical markers were compared between the participant groups.