Multi-factorial risk stratification in Acute Coronary Syndrome

Background: ST elevated myocardial infarction (STEMI), non-ST elevated myocardial infarction (NSTEMI) and unstable anginas (UA) are continual spectrum of coronary artery disease (CAD). These are terminal events arising as a result of coronary artery atherosclerosis and superimposed thrombosis. Materials and methods: A prospective study in which a total of 91 patients of either sex aged 20 to 60 years were recruited, of which 30 were STEMI, 31 were NSTEMI/ unstable angina and 30 were age and sex matched healthy controls. Patients with following complaints of maximum 24 hours duration were registered in the emergency department and were included in the study (ACC/AHA Guidelines, 2002). Results: In the present study, 91 subjects were recruited from medical emergency department. All of the subjects were meeting the inclusion criteria. Of the total 91 subjects 30 were of STEMI (Group 1), 15 were of NSTEMI (Group 2), 16 were of unstable angina (Group 3) and 30 were controls (Group 4). Conclusion: In patients of ACS, MPO is raised as compared to controls. Also in complicated ACS, irrespective of other risk factors, MPO was significantly raised as compared to controls and can be used to predict immediate clinical complication. There is no significant association between MPO, hs CRP and CK-MB when taken together to predict complications. TIMI risk score is a simple prognostication scheme that categorizes a patient's risk of death and ischemic events and provides a basis for therapy.