Coronary angiographic findings and clinical characteristics in patients with ST-elevation myocardial infarction: A cross-sectional study

Coronary angiographic findings and clinical characteristics in patients with ST-elevation myocardial infarction: A cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Coronary angiographic findings and clinical characteristics in patients with ST-elevation myocardial infarction: A cross-sectional study Abolfazl Jand, Abdollah amirfarhangi, seyed hashem Sezavar, Maryam Naderi, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4155722/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Coronary artery disease (CAD) is one of the most common causes of mortality worldwide. Several studies have demonstrated that some areas of the coronary arteries are more prone to thrombosis. This study investigated the associations between angiographic findings and risk factors for coronary artery disease. Methods : This cross-sectional study investigated the total number of patients with ST-elevation myocardial infarction (STEMI) referred to the angiography department at Hazrat-E-Rasool Hospital from 21st March 2017 to 20th March 2018. All patients underwent standard coronary angiography; if necessary, a stent was deployed in the infarct-related artery (IRA). The referrals were made through emergency medical services (EMS) or the hospital's emergency department. Results : Fifty-two patients were enrolled as STEMI patients and underwent coronary angiography at Hazrat-E-Rasool Hospital in 1396. The mean age of the patients was 59.7±12.7 years, and 78.9% were males. The most frequently involved vessels were the left anterior descending (LAD), right coronary artery (RCA), and left circumflex(LCX) Most lesions in the LAD were located in the mid-segment, while in the RCA and LCX, the involvement predominantly occurred in the proximal segment. Conclusions : The results of our study demonstrated that the LAD artery is the most commonly involved vessel. Additionally, male sex, family history, and smoking are considered risk factors at a younger age, while diabetes, hypertension, and chronic kidney disease (CKD) play significant roles in older generations. Coronary angiography Coronary artery disease Myocardial infarction Background Coronary artery disease (CAD) is one of the most common chronic, progressive, and life-threatening conditions [1] and accounts for one-third of all deaths worldwide. The prevalence of this disease has been rapidly increasing in developing countries in recent years, with 78% of the mortality in these countries attributed to coronary artery disease [2], leading to a significant depletion of societal financial resources [2]. According to available statistics in Iran, 46% of overall mortality in the population is caused by coronary artery disease, ranking it as the leading cause of death in both sexes [3, 4]. Therefore, this disease presents a significant health and treatment challenge in societies and can be mitigated by examining and controlling risk factors, early diagnosis, and appropriate treatment [5]. According to the text, coronary artery disease can encompass a broad spectrum of conditions ranging from asymptomatic ischemia to unstable angina, acute myocardial infarction (MI), ischemic cardiomyopathy, sudden cardiac death, arrhythmias, and cardiogenic shock. The underlying pathology in MI patients involves plaque rupture and subsequent thrombus formation [6, 7]. Several studies have shown that some areas of the coronary arteries are more prone to thrombosis [8, 9]. Clinical and pathological findings have demonstrated that the proximal and mid-segments of the coronary arteries are the most common sites for plaque rupture [10-15]. Therefore, various factors may affect plaque formation and location. In some studies, different anatomical parameters, such as side branches in the proximal segment, bifurcation, and bends, have been considered influential on plaque formation and progression and are influenced by hemodynamic parameters [16]. Moreover, numerous background risk factors can contribute to the development and progression of coronary artery disease, including male sex, smoking status or exposure to secondhand smoke, obesity, poor diet, hypertension, diabetes, hormone therapy, and psychosocial factors such as depression and stress [17, 18]. Since there has been limited research on the anatomical findings of coronary arteries and culprit lesions and their association with risk factors for coronary artery disease in Iran, this study aimed to investigate this hypothesis. Methods Study design This cross-sectional study investigated the total number of STEMI patients referred to the angiography department of Hazrat-E-Rasool Hospital through EMS or hospital emergency services from 21st March 2017 to 20th March 2018. All available data in paper-based and electronic format were obtained from the institutional medical records department. Basic information, including age, sex, previous medical history, type of STEMI, time from first encounter to stent placement, total ischemic time, and laboratory findings, including troponin, creatinine, blood glucose, lipid profile (TG, cholesterol, LDL, HDL), and EF level, was retrieved from the hospital archives . All patients in this study underwent standard coronary angiography and stent implantation in the occluded vessel if necessary. All patients signed informed consent before coronary angiography . A single person reviewed all angiographic films to determine the number and segment of involved vessels. The study accepted by the Scientific and Ethic Review Committee of the Iran university of medical sciences, Reference number # IR.IUMS.FMD.REC.1399.678. Statistical analysis Qualitative variables are reported as percentages and frequencies, while quantitative variables are reported as the mean ± standard deviation. Independent t tests were used for comparing means, and chi-square tests were used for qualitative variables. A significance level of 0.05 was used, and all the data were analyzed using SPSS version 21 software. Results In total, 502 patients were diagnosed with STEMI and underwent coronary angiography at Hazrat-E-Rasool Hospital in 2017; their demographic information is summarized in Table 1. The majority of involved segments were in the mid-portion of the LAD (59.6%), followed by the LCX (50%) and RCA (48.6%) in the proximal segment (P=0.0001). The prevalence of various risk factors did not play a role in the type of coronary artery involvement. The only significant difference between females and males was observed for most myocardial infarctions in the LCX segment. Refer to Table 2 for further details. The study's results showed that age, diabetes status, hypertension, previous history of heart disease, family history, and CKD were significantly associated with the number of involved vessels (p<0.05). Discussion The results of our study showed that the highest rate of MI occurred in the LAD, RCA, and LCX arteries. The most involved segment in the LAD was the mid-segment, while it was proximal to the RCA and LCX. In Wang's study, the highest rate of MI occurred in the RCA (44%) and LAD (39%) arteries, with one-third of proximal vessels being the most involved site [14]. Gibson and colleagues showed that the distance between the stenosis and the lesion varied depending on the type of artery, with the least distance observed in the LAD, followed by the LCX and RCA [12]. This phenomenon was also observed in an extensive study of 30,386 non-STEMI patients [19]. In contrast to our study, Bejani et al. demonstrated that the incidence of inferior MI was greater in these regions than in other regions[20]. Another study also supported our findings that the incidence of STEMI was highest in the LAD (56%), followed by the RCA (42%) and LCX (24%) [21]. Although information regarding the distribution of lesions is crucial, why plaques in the LCX are less prone to rupture or why involvement in the proximal segments is more susceptible to rupture remains controversial . Ischemic events in the LCX are less common because the standard 12-lead ECG has limited sensitivity for detecting ischemia in the lateral and posterior regions [22, 23]. Previous studies have shown that, on electrocardiogram, only 33% of patients with LCX occlusion exhibit ST elevation [24]. Frome et al. also justified this hypothesis by demonstrating that patients with LCX occlusion had less ST elevation and were less frequently referred for primary PCI [22]. Another reason for the lower incidence of culprit lesions in the LCX is anatomical differences compared to those in the LAD and RCA. Since a large portion of the population has a small LCX with fewer side branches, occlusion of this region can result in non-STEMI or no changes in the ECG [22, 24]. According to our study findings, various risk factors do not play a role in the involvement of different coronary artery segments. Our results are consistent with those of Antony's study, except for a previous history of MI. Unlike us, they concluded that patients with prior MI mostly had lesions in the distal segment of the vessel [25]. In another study of nondiabetic patients, MI occurred more frequently in the proximal segments. However, other risk factors, similar to our findings, did not play a role in the involvement of the infarct-related artery (IRA) segment [12]. Our study showed that the percentage of MI on the LCX was significantly greater in females. However, Valente et al. reported no sex difference in the IRA [26]. Other studies have confirmed this finding [27]. Our study demonstrated that male sex, family history, and smoking are risk factors for in younger age groups, but diabetes, hypertension, and CKD play a role in older age groups. Various studies have identified smoking as the most critical risk factor for MI in individuals under 40 years of age [28-30]. Conclusion In summary, the results of our study showed that the LAD artery is the most common vessel involved. Additionally, male sex, family history, and smoking are considered risk factors at a younger age, while diabetes, hypertension, and CKD play a role in older generations. Abbreviations CAD Coronary artery disease CKD chronic kidney disease EMS emergency medical services IRA infarct-related artery LAD left anterior descending LCX left circumflex RCA right coronary artery STEMI ST-elevation myocardial infarction Declarations Acknowledgements We are very grateful to the study participants and data collection teams of Hazrat-E-Rasool Hospital Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Contributions Conception and design AA. Data acquisition and analysis AJ and MN. Drafting of the work BE. Revised and reviewed the article SS. All authors approved the final version of the manuscript. Ethics declarations Ethics approval and consent to participate: Ethical approval for the study was provided by the Iran University of Medical Sciences Research Ethics Committee # IR.IUMS.FMD.REC.1399.678. Consent for publication Not applicable . Funding: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Competing interests : None declared Data availability statement All available data in paper-based and electronic format were obtained from the institutional medical records department. The data are available upon reasonable request and Jand A is responsible. Patient and public involvement: Patients and/or the public were not involved in the design, conduct, reporting, or dissemination of this research. References Hejazi F, Hosseinzadeh F, Irani Rad L, Bagheri A, Vahedian M, Damanpak V: Effectiveness of Celox powder and standard dressing in control of angiography location bleeding . Journal of Babol University of Medical Sciences 2013, 15 (4):30-36. Krishnan MN, Zachariah G, Venugopal K, Mohanan PP, Harikrishnan S, Sanjay G, Jeyaseelan L, Thankappan KR: Prevalence of coronary artery disease and its risk factors in Kerala, South India: a community-based cross-sectional study . BMC Cardiovasc Disord 2016, 16 :12. Abdollahi A, Sh M, Behnampour N, Kordnezhad A: Effect of changing position and early ambulation on the bleeding, hematoma and urinary retention in patients with coronary angiography . Journal of Gorgan University of Medical Sciences 2013, 15 (3):7-12. Sh V, Keshavarz S, Nikbakhtnasrabadi A, Shamsizadeh M, Kazemnejad A: The effect of orientation tour with angiography procedure on anxiety and satisfaction of patients undergoing coronary angiography . Iranian Journal of Psychiatric Nursing 2013, 1 (2):1-10. Hanifi N, Bahraminejad N, MIRZAEI KAT, Ahmadi F, Khani M, Taran L: The effect of orientation program on stress, anxiety and depression of patients undergoing coronary angiography . Iran J Nurs Res 2012, 12 :1-8. Fuster V, Badimon L, Badimon JJ, Chesebro JH: The pathogenesis of coronary artery disease and the acute coronary syndromes (1) . N Engl J Med 1992, 326 (4):242-250. Mann J, Davies MJ: Mechanisms of progression in native coronary artery disease: role of healed plaque disruption . Heart 1999, 82 (3):265-268. Falk E, Shah PK, Fuster V: Coronary plaque disruption . Circulation 1995, 92 (3):657-671. Katritsis DG, Pantos J, Efstathopoulos E: Hemodynamic factors and atheromatic plaque rupture in the coronary arteries: from vulnerable plaque to vulnerable coronary segment . Coron Artery Dis 2007, 18 (3):229-237. el Fawal MA, Berg GA, Wheatley DJ, Harland WA: Sudden coronary death in Glasgow: nature and frequency of acute coronary lesions . Br Heart J 1987, 57 (4):329-335. Fox B, James K, Morgan B, Seed A: Distribution of fatty and fibrous plaques in young human coronary arteries . Atherosclerosis 1982, 41 (2-3):337-347. Gibson CM, Kirtane AJ, Murphy SA, Karha J, Cannon CP, Giugliano RP, Roe MT, Harrington RA, Ohman EM, Antman EM: Distance from the coronary ostium to the culprit lesion in acute ST-elevation myocardial infarction and its implications regarding the potential prevention of proximal plaque rupture . Journal of thrombosis and thrombolysis 2003, 15 (3):189-196. Hochman JS, Phillips WJ, Ruggieri D, Ryan SF: The distribution of atherosclerotic lesions in the coronary arterial tree: relation to cardiac risk factors . Am Heart J 1988, 116 (5 Pt 1):1217-1222. Wang JC, Normand SL, Mauri L, Kuntz RE: Coronary artery spatial distribution of acute myocardial infarction occlusions . Circulation 2004, 110 (3):278-284. Virmani R, Burke AP, Farb A, Kolodgie FD: Pathology of the vulnerable plaque . J Am Coll Cardiol 2006, 47 (8 Suppl):C13-18. Katritsis DG, Efstathopoulos EP, Pantos J, Korovesis S, Kourlaba G, Kazantzidis S, Marmarelis V, Voridis E: Anatomic characteristics of culprit sites in acute coronary syndromes . J Interv Cardiol 2008, 21 (2):140-150. Heravi Y, Mojdekanlu M, Seyed Sharifi S, Yaghubi M: Role of cardiovascular risk factors in involvement of coronary arteries A predictive model in angiographic study . Journal of North Khorasan University of Medical Sciences 2014, 6 (1):199-205. Ramamurthy G, Trejo E, Faraone SV: Depression treatment in patients with coronary artery disease: a systematic review . Prim Care Companion CNS Disord 2013, 15 (5). Dixon WC, Wang TY, Dai D, Shunk KA, Peterson ED, Roe MT, Registry NCD: Anatomic distribution of the culprit lesion in patients with non–ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: findings from the National Cardiovascular Data Registry . Journal of the American College of Cardiology 2008, 52 (16):1347-1348. Mostafa B, Hojatolah N, Ali Asghar K, Afsaneh G, Najimeh B, Gholam Ali Hk: Evaluation of acute myocardial infarction management guidelinesindicators (Stent save a life, code 247) in patientsreferred to cardiology Department of Valiasr Hospital in Fasa, Southwest of Iran 2019 . Revista Latinoamericana de Hipertensión 2020, 15 (1):1-8. Sezavar SH, Hassanzadeh M, Moayed DA, Tabandeh M, Ghasemi M, Abdi S, Firoozi I, Golbidi P, Pourjafari M, Taslimi N: Current practice of percutaneous coronary intervention on patients with acute coronary syndrome in Iran: A prospective observational study . Medical journal of the Islamic Republic of Iran 2020, 34 :13. From AM, Best PJ, Lennon RJ, Rihal CS, Prasad A: Acute myocardial infarction due to left circumflex artery occlusion and significance of ST-segment elevation . The American journal of cardiology 2010, 106 (8):1081-1085. Schmitt C, Schmieder S, Karch M, Neumann F-J, Scho A: Diagnosis of acute myocardial infarction in angiographically documented occluded infarct vessel: limitations of ST-segment elevation in standard and extended ECG leads . Chest 2001, 120 (5):1540-1546. Shah A, Wagner GS, Green CL, Crater SW, Sawchak ST, Wildermann NM, Mark DB, Waugh RA, Krucoff MW: Electrocardiographic differentiation of the ST-segment depression of acute myocardial injury due to the left circumflex artery occlusion from that of myocardial ischemia of nonocclusive etiologies . The American journal of cardiology 1997, 80 (4):512-513. Antoni ML, Yiu K-H, Atary JZ, Delgado V, Holman ER, van der Wall EE, Schuijf JD, Bax JJ, Schalij MJ: Distribution of culprit lesions in patients with ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention . Coronary artery disease 2011, 22 (8):533-536. Valente S, Lazzeri C, Chiostri M, Giglioli C, Zucchini M, Grossi F, Gensini GF: Gender-related difference in ST-elevation myocardial infarction treated with primary angioplasty: a single-centre 6-year registry . European journal of preventive cardiology 2012, 19 (2):233-240. Antoniucci D, Valenti R, Moschi G, Migliorini A, Trapani M, Santoro GM, Bolognese L, Dovellini EV: Sex-based differences in clinical and angiographic outcomes after primary angioplasty or stenting for acute myocardial infarction . The American journal of cardiology 2001, 87 (3):289-293. Zimmerman FH, Cameron A, Fisher LD, Grace N: Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry) . Journal of the American College of Cardiology 1995, 26 (3):654-661. Mukherjee D, Hsu A, Moliterno DJ, Lincoff AM, Goormastic M, Topol EJ: Risk factors for premature coronary artery disease and determinants of adverse outcomes after revascularization in patients≤ 40 years old . The American journal of cardiology 2003, 92 (12):1465-1467. Bhardwaj R, Kandoria A, Sharma R: Myocardial infarction in young adults-risk factors and pattern of coronary artery involvement . Nigerian medical journal: journal of the Nigeria Medical Association 2014, 55 (1):44. Tables Table 1. Demographic information and comorbidities Variable 12.7±59.7 Age (mean±SD) (%78.9)396 Male (%33.7)164 FH (%26.7)131 DM (%41.6)204 HTN (%23.3)114 Dyslipidemia (18.2%)88 CKD (%40.7)198 Current smoker (%27.5)133 Prior IHD (%4)20 Prior CABG (%4.9)24 Prior Stroke (%16.8)82 Opium addiction 11.08±40.3 Ejection Fraction (mean±SD) (%6.3)28 Mortality (in hospital) 88.2±88.71 FMC to PCI Time (min) 193.3±250.84 Total ischemic time (min) (45.6%)226 Anterior STEMI (26.4%)131 Inferior STEMI (18.3%)91 Posterior STEMI (9.7%)48 No-STEMI Table 2. Risk factor prevalence across different infarct-related arteries P value RCA LCX LAD 0.01 (72.9%)114 (66.2%)45 (83.3%)189 Male (20.8%)30 (33.8%)23 (16.7%)38 Female 0.196 (33.6%)48 (44.8%)30 (33.2%)73 FH 0.743 (28.7%)41 (23.9%)16 (26.1%)58 DM 0.338 (43.4%)62 (49.3%)33 (39.4%)87 HTN 0.783 (25.2%)36 (20.9%)14 (23.2%)51 Dyslipidemia 0.99 (17.4%)25 (17.9%)12 (17.4%)38 CKD 0.38 (51%)73 (44.8%)30 (54.3%)119 Current smoker 0.66 (23.1%)33 (19.4%)13 (24.5%)54 Opium 0.87 (24.6%)35 (27.7%18 (24.7%)54 Prior IHD 0.443 (3.5%)5 (7.5%)5 (4.5%)10 Prior Stroke Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4155722","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":288619690,"identity":"dae07210-b4f9-4466-b9d2-a5e3cf6945cf","order_by":0,"name":"Abolfazl Jand","email":"","orcid":"","institution":"Iran University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Abolfazl","middleName":"","lastName":"Jand","suffix":""},{"id":288619691,"identity":"c3a8f2da-43f7-4c23-bc78-e5021f600daf","order_by":1,"name":"Abdollah amirfarhangi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9klEQVRIiWNgGAWjYJCCAww2DAwGIFZCBZRBWEsaTMsZIrUwwLUwthGhhb/9dOLhigS7fHP2s4dfPJx3WN6cvfkAw4+KbTi1SJzJ3XDwTEKy5c6evDSLxG2HDXf2HEtg7DlzG49HgFoafzAbGBzIMTMAamHccCPHgJmxDbcW+fNvNxxsSKg3MDj/BqhlzmF7gloMbuSCtBw2MLiRY/wgseFwIkEthjfAthwHanljxpBwLD15w5ljCQfx+UXufO7mjw0J1UCH5Rh//FFjbbvhePPBBz8q8HgfCbBJMDA0g1kHiFIPBMwfGBjqiFU8CkbBKBgFIwgAAK6UZh3HIbuDAAAAAElFTkSuQmCC","orcid":"","institution":"Iran University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Abdollah","middleName":"","lastName":"amirfarhangi","suffix":""},{"id":288619692,"identity":"a0ed677f-a5b2-467c-a4b4-9f71227de5a6","order_by":2,"name":"seyed hashem Sezavar","email":"","orcid":"","institution":"Iran University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"seyed","middleName":"hashem","lastName":"Sezavar","suffix":""},{"id":288619693,"identity":"929146d9-421a-41c5-845c-f150373c9de9","order_by":3,"name":"Maryam Naderi","email":"","orcid":"","institution":"Iranian Blood Transfusion Organization","correspondingAuthor":false,"prefix":"","firstName":"Maryam","middleName":"","lastName":"Naderi","suffix":""},{"id":288619694,"identity":"8b9047a7-d4fc-4413-8c74-0580790a8530","order_by":4,"name":"Babak eshrati","email":"","orcid":"","institution":"Iran University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Babak","middleName":"","lastName":"eshrati","suffix":""}],"badges":[],"createdAt":"2024-03-23 20:29:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4155722/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4155722/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":59995523,"identity":"685ee4e4-6551-4757-8d78-f3e66afbb2d5","added_by":"auto","created_at":"2024-07-10 09:25:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1267072,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4155722/v1/e28786eb-becb-4411-9e5a-9690b07e09f9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Coronary angiographic findings and clinical characteristics in patients with ST-elevation myocardial infarction: A cross-sectional study","fulltext":[{"header":"Background","content":"\u003cp\u003eCoronary artery disease (CAD) is one of the most common chronic, progressive, and life-threatening conditions\u0026nbsp;[1]\u0026nbsp;and accounts for one-third of all deaths worldwide. The prevalence of this disease has been rapidly increasing in developing countries in recent years, with 78% of the mortality in these countries attributed to coronary artery disease\u0026nbsp;[2], leading to a significant depletion of societal financial resources\u0026nbsp;[2]. According to available statistics in Iran, 46% of overall mortality in the population is caused by coronary artery disease, ranking it as the leading cause of death in both sexes\u0026nbsp;[3, 4]. Therefore, this disease presents a significant health and treatment challenge in societies and can be mitigated by examining and controlling risk factors, early diagnosis, and appropriate treatment\u0026nbsp;[5].\u003c/p\u003e\n\u003cp\u003eAccording to the text, coronary artery disease can encompass a broad spectrum of conditions ranging from asymptomatic ischemia to unstable angina, acute myocardial infarction (MI), ischemic cardiomyopathy, sudden cardiac death, arrhythmias, and cardiogenic shock. The underlying pathology in MI patients involves plaque rupture and subsequent thrombus formation [6, 7]. Several studies have shown that some areas of the coronary arteries are more prone to thrombosis [8, 9]. Clinical and pathological findings have demonstrated that the proximal and mid-segments of the coronary arteries are the most common sites for plaque rupture [10-15]. Therefore, various factors may affect plaque formation and location. In some studies, different anatomical parameters, such as side branches in the proximal segment, bifurcation, and bends, have been considered influential on plaque formation and progression and are influenced by hemodynamic parameters [16]. Moreover, numerous background risk factors can contribute to the development and progression of coronary artery disease, including male sex, smoking status or exposure to secondhand smoke, obesity, poor diet, hypertension, diabetes, hormone therapy, and psychosocial factors such as depression and stress [17, 18]. Since there has been limited research on the anatomical findings of coronary arteries and culprit lesions and their association with risk factors for coronary artery disease in Iran, this study aimed to investigate this hypothesis.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional study investigated the total number of STEMI patients referred to the angiography department of Hazrat-E-Rasool Hospital through EMS or hospital emergency services from 21st March 2017 to 20th March 2018. All available data in paper-based and electronic format were obtained from the institutional medical records department. Basic information, including age, sex, previous medical history, type of STEMI, time from first encounter to stent placement, total ischemic time, and laboratory findings, including troponin, creatinine, blood glucose, lipid profile (TG, cholesterol, LDL, HDL), and EF level, was retrieved from the hospital archives\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eAll patients in this study underwent standard coronary angiography and stent implantation in the occluded vessel if necessary. \u003cu\u003eAll patients signed informed consent before coronary angiography\u003c/u\u003e. A single person reviewed all angiographic films to determine the number and segment of involved vessels. The study accepted by the Scientific and Ethic Review Committee of the Iran university of medical sciences, Reference number # IR.IUMS.FMD.REC.1399.678.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQualitative variables are reported as percentages and frequencies, while quantitative variables are reported as the mean \u0026plusmn; standard deviation. Independent t tests were used for comparing means, and chi-square tests were used for qualitative variables. A significance level of 0.05 was used, and all the data were analyzed using SPSS version 21 software.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn total, 502 patients were diagnosed with STEMI and underwent coronary angiography at Hazrat-E-Rasool Hospital in 2017; their demographic information is summarized in Table 1.\u003c/p\u003e\n\u003cp\u003eThe majority of involved segments were in the mid-portion of the LAD (59.6%), followed by the LCX (50%) and RCA (48.6%) in the proximal segment (P=0.0001). The prevalence of various risk factors did not play a role in the type of coronary artery involvement. The only significant difference between females and males was observed for most myocardial infarctions in the LCX segment. Refer to Table 2 for further details.\u003c/p\u003e\n\u003cp\u003eThe study\u0026apos;s results showed that age, diabetes status, hypertension, previous history of heart disease, family history, and CKD were significantly associated with the number of involved vessels (p\u0026lt;0.05).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe results of our study showed that the highest rate of MI occurred in the LAD, RCA, and LCX arteries. The most involved segment in the LAD was the mid-segment, while it was proximal to the RCA and LCX. In Wang\u0026apos;s study, the highest rate of MI occurred in the RCA (44%) and LAD (39%) arteries, with one-third of proximal vessels being the most involved site\u0026nbsp;[14]. Gibson and colleagues showed that the distance between the stenosis and the lesion varied depending on the type of artery, with the least distance observed in the LAD, followed by the LCX and RCA\u0026nbsp;[12]. This phenomenon was also observed in an extensive study of 30,386 non-STEMI patients\u0026nbsp;[19].\u003c/p\u003e\n\u003cp\u003eIn contrast to our study, Bejani et al. demonstrated that the incidence of inferior MI was greater in these regions than in other regions[20]. Another study also supported our findings that the incidence of STEMI was highest in the LAD (56%), followed by the RCA (42%) and LCX (24%)\u0026nbsp;[21]. Although information regarding the distribution of lesions is crucial, why plaques in the LCX are less prone to rupture or why involvement in the proximal segments is more susceptible to rupture remains controversial\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Ischemic events in the LCX are less common because the standard 12-lead ECG has limited sensitivity for detecting ischemia in the lateral and posterior regions\u0026nbsp;[22, 23]. Previous studies have shown that, on electrocardiogram, only 33% of patients with LCX occlusion exhibit ST elevation\u0026nbsp;[24]. Frome et al. also justified this hypothesis by demonstrating that patients with LCX occlusion had less ST elevation and were less frequently referred for primary PCI\u0026nbsp;[22].\u003c/p\u003e\n\u003cp\u003eAnother reason for the lower incidence of culprit lesions in the LCX is anatomical differences compared to those in the LAD and RCA. Since a large portion of the population has a small LCX with fewer side branches, occlusion of this region can result in non-STEMI or no changes in the ECG\u0026nbsp;[22, 24].\u003c/p\u003e\n\u003cp\u003eAccording to our study findings, various risk factors do not play a role in the involvement of different coronary artery segments. Our results are consistent with those of Antony\u0026apos;s study, except for a previous history of MI. Unlike us, they concluded that patients with prior MI mostly had lesions in the distal segment of the vessel\u0026nbsp;[25]. In another study of nondiabetic patients, MI occurred more frequently in the proximal segments. However, other risk factors, similar to our findings, did not play a role in the involvement of the infarct-related artery (IRA) segment\u0026nbsp;[12].\u003c/p\u003e\n\u003cp\u003eOur study showed that the percentage of MI on the LCX was significantly greater in females. However, Valente et al. reported no sex difference in the IRA\u0026nbsp;[26]. Other studies have confirmed this finding\u0026nbsp;[27].\u003c/p\u003e\n\u003cp\u003eOur study demonstrated that male sex, family history, and smoking are risk factors for in younger age groups, but diabetes, hypertension, and CKD play a role in older age groups. Various studies have identified smoking as the most critical risk factor for MI in individuals under 40 years of age [28-30].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn summary, the results of our study showed that the LAD artery is the most common vessel involved. Additionally, male sex, family history, and smoking are considered risk factors at a younger age, while diabetes, hypertension, and CKD play a role in older generations.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCAD \u0026nbsp;Coronary artery disease\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCKD \u0026nbsp;chronic kidney disease\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEMS \u0026nbsp;emergency medical services\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIRA \u0026nbsp;infarct-related artery\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLAD \u0026nbsp;left anterior descending\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLCX \u0026nbsp;left circumflex\u003c/p\u003e\n\u003cp\u003eRCA \u0026nbsp;right coronary artery\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSTEMI \u0026nbsp;ST-elevation myocardial infarction\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eWe are very grateful to the study participants and data collection teams of Hazrat-E-Rasool Hospital\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eThe authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eContributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eConception and design AA. Data acquisition and analysis AJ and MN. Drafting of the work BE. Revised and reviewed the article SS. All authors approved the final version of the manuscript.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eEthics declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eEthical approval for the study was provided by the Iran University of Medical Sciences Research Ethics Committee # IR.IUMS.FMD.REC.1399.678.\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eNot applicable\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eThe authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e: None declared\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eData availability statement\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eAll available data in paper-based and electronic format were obtained from the institutional medical records department. \u003cu\u003eThe data are available upon reasonable request\u003c/u\u003e\u003cu\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/u\u003e\u003cu\u003eand Jand A is responsible.\u0026nbsp;\u003c/u\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003ePatient and public involvement:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003ePatients and/or the public were not involved in the design, conduct, reporting, or dissemination of this research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli dir=\"LTR\"\u003eHejazi F, Hosseinzadeh F, Irani Rad L, Bagheri A, Vahedian M, Damanpak V: \u003cstrong\u003eEffectiveness of Celox powder and standard dressing in control of angiography location bleeding\u003c/strong\u003e. \u003cem\u003eJournal of Babol University of Medical Sciences \u003c/em\u003e2013, \u003cstrong\u003e15\u003c/strong\u003e(4):30-36.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003eKrishnan MN, Zachariah G, Venugopal K, Mohanan PP, Harikrishnan S, Sanjay G, Jeyaseelan L, Thankappan KR: \u003cstrong\u003ePrevalence of coronary artery disease and its risk factors in Kerala, South India: a community-based cross-sectional study\u003c/strong\u003e. \u003cem\u003eBMC Cardiovasc Disord \u003c/em\u003e2016, \u003cstrong\u003e16\u003c/strong\u003e:12.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003eAbdollahi A, Sh M, Behnampour N, Kordnezhad A: \u003cstrong\u003eEffect of changing position and early ambulation on the bleeding, hematoma and urinary retention in patients with coronary angiography\u003c/strong\u003e. \u003cem\u003eJournal of Gorgan University of Medical Sciences \u003c/em\u003e2013, \u003cstrong\u003e15\u003c/strong\u003e(3):7-12.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003eSh V, Keshavarz S, Nikbakhtnasrabadi A, Shamsizadeh M, Kazemnejad A: \u003cstrong\u003eThe effect of orientation tour with angiography procedure on anxiety and satisfaction of patients undergoing coronary angiography\u003c/strong\u003e. \u003cem\u003eIranian Journal of Psychiatric Nursing \u003c/em\u003e2013, \u003cstrong\u003e1\u003c/strong\u003e(2):1-10.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003eHanifi N, Bahraminejad N, MIRZAEI KAT, Ahmadi F, Khani M, Taran L: \u003cstrong\u003eThe effect of orientation program on stress, anxiety and depression of patients undergoing coronary angiography\u003c/strong\u003e. \u003cem\u003eIran J Nurs Res \u003c/em\u003e2012, \u003cstrong\u003e12\u003c/strong\u003e:1-8.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003eFuster V, Badimon L, Badimon JJ, Chesebro JH: \u003cstrong\u003eThe pathogenesis of coronary artery disease and the acute coronary syndromes (1)\u003c/strong\u003e. \u003cem\u003eN Engl J Med \u003c/em\u003e1992, \u003cstrong\u003e326\u003c/strong\u003e(4):242-250.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003eMann J, Davies MJ: \u003cstrong\u003eMechanisms of progression in native coronary artery disease: role of healed plaque disruption\u003c/strong\u003e. \u003cem\u003eHeart \u003c/em\u003e1999, \u003cstrong\u003e82\u003c/strong\u003e(3):265-268.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003eFalk E, Shah PK, Fuster V: \u003cstrong\u003eCoronary plaque disruption\u003c/strong\u003e. \u003cem\u003eCirculation \u003c/em\u003e1995, \u003cstrong\u003e92\u003c/strong\u003e(3):657-671.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003eKatritsis DG, Pantos J, Efstathopoulos E: \u003cstrong\u003eHemodynamic factors and atheromatic plaque rupture in the coronary arteries: from vulnerable plaque to vulnerable coronary segment\u003c/strong\u003e. \u003cem\u003eCoron Artery Dis \u003c/em\u003e2007, \u003cstrong\u003e18\u003c/strong\u003e(3):229-237.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e el Fawal MA, Berg GA, Wheatley DJ, Harland WA: \u003cstrong\u003eSudden coronary death in Glasgow: nature and frequency of acute coronary lesions\u003c/strong\u003e. \u003cem\u003eBr Heart J \u003c/em\u003e1987, \u003cstrong\u003e57\u003c/strong\u003e(4):329-335.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Fox B, James K, Morgan B, Seed A: \u003cstrong\u003eDistribution of fatty and fibrous plaques in young human coronary arteries\u003c/strong\u003e. \u003cem\u003eAtherosclerosis \u003c/em\u003e1982, \u003cstrong\u003e41\u003c/strong\u003e(2-3):337-347.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Gibson CM, Kirtane AJ, Murphy SA, Karha J, Cannon CP, Giugliano RP, Roe MT, Harrington RA, Ohman EM, Antman EM: \u003cstrong\u003eDistance from the coronary ostium to the culprit lesion in acute ST-elevation myocardial infarction and its implications regarding the potential prevention of proximal plaque rupture\u003c/strong\u003e. \u003cem\u003eJournal of thrombosis and thrombolysis \u003c/em\u003e2003, \u003cstrong\u003e15\u003c/strong\u003e(3):189-196.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Hochman JS, Phillips WJ, Ruggieri D, Ryan SF: \u003cstrong\u003eThe distribution of atherosclerotic lesions in the coronary arterial tree: relation to cardiac risk factors\u003c/strong\u003e. \u003cem\u003eAm Heart J \u003c/em\u003e1988, \u003cstrong\u003e116\u003c/strong\u003e(5 Pt 1):1217-1222.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Wang JC, Normand SL, Mauri L, Kuntz RE: \u003cstrong\u003eCoronary artery spatial distribution of acute myocardial infarction occlusions\u003c/strong\u003e. \u003cem\u003eCirculation \u003c/em\u003e2004, \u003cstrong\u003e110\u003c/strong\u003e(3):278-284.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Virmani R, Burke AP, Farb A, Kolodgie FD: \u003cstrong\u003ePathology of the vulnerable plaque\u003c/strong\u003e. \u003cem\u003eJ Am Coll Cardiol \u003c/em\u003e2006, \u003cstrong\u003e47\u003c/strong\u003e(8 Suppl):C13-18.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Katritsis DG, Efstathopoulos EP, Pantos J, Korovesis S, Kourlaba G, Kazantzidis S, Marmarelis V, Voridis E: \u003cstrong\u003eAnatomic characteristics of culprit sites in acute coronary syndromes\u003c/strong\u003e. \u003cem\u003eJ Interv Cardiol \u003c/em\u003e2008, \u003cstrong\u003e21\u003c/strong\u003e(2):140-150.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Heravi Y, Mojdekanlu M, Seyed Sharifi S, Yaghubi M: \u003cstrong\u003eRole of cardiovascular risk factors in involvement of coronary arteries A predictive model in angiographic study\u003c/strong\u003e. \u003cem\u003eJournal of North Khorasan University of Medical Sciences \u003c/em\u003e2014, \u003cstrong\u003e6\u003c/strong\u003e(1):199-205.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Ramamurthy G, Trejo E, Faraone SV: \u003cstrong\u003eDepression treatment in patients with coronary artery disease: a systematic review\u003c/strong\u003e. \u003cem\u003ePrim Care Companion CNS Disord \u003c/em\u003e2013, \u003cstrong\u003e15\u003c/strong\u003e(5).\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Dixon WC, Wang TY, Dai D, Shunk KA, Peterson ED, Roe MT, Registry NCD: \u003cstrong\u003eAnatomic distribution of the culprit lesion in patients with non\u0026ndash;ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: findings from the National Cardiovascular Data Registry\u003c/strong\u003e. \u003cem\u003eJournal of the American College of Cardiology \u003c/em\u003e2008, \u003cstrong\u003e52\u003c/strong\u003e(16):1347-1348.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Mostafa B, Hojatolah N, Ali Asghar K, Afsaneh G, Najimeh B, Gholam Ali Hk: \u003cstrong\u003eEvaluation of acute myocardial infarction management guidelinesindicators (Stent save a life, code 247) in patientsreferred to cardiology Department of Valiasr Hospital in Fasa, Southwest of Iran 2019\u003c/strong\u003e. \u003cem\u003eRevista Latinoamericana de Hipertensi\u0026oacute;n \u003c/em\u003e2020, \u003cstrong\u003e15\u003c/strong\u003e(1):1-8.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Sezavar SH, Hassanzadeh M, Moayed DA, Tabandeh M, Ghasemi M, Abdi S, Firoozi I, Golbidi P, Pourjafari M, Taslimi N: \u003cstrong\u003eCurrent practice of percutaneous coronary intervention on patients with acute coronary syndrome in Iran: A prospective observational study\u003c/strong\u003e. \u003cem\u003eMedical journal of the Islamic Republic of Iran \u003c/em\u003e2020, \u003cstrong\u003e34\u003c/strong\u003e:13.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e From AM, Best PJ, Lennon RJ, Rihal CS, Prasad A: \u003cstrong\u003eAcute myocardial infarction due to left circumflex artery occlusion and significance of ST-segment elevation\u003c/strong\u003e. \u003cem\u003eThe American journal of cardiology \u003c/em\u003e2010, \u003cstrong\u003e106\u003c/strong\u003e(8):1081-1085.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Schmitt C, Schmieder S, Karch M, Neumann F-J, Scho A: \u003cstrong\u003eDiagnosis of acute myocardial infarction in angiographically documented occluded infarct vessel: limitations of ST-segment elevation in standard and extended ECG leads\u003c/strong\u003e. \u003cem\u003eChest \u003c/em\u003e2001, \u003cstrong\u003e120\u003c/strong\u003e(5):1540-1546.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Shah A, Wagner GS, Green CL, Crater SW, Sawchak ST, Wildermann NM, Mark DB, Waugh RA, Krucoff MW: \u003cstrong\u003eElectrocardiographic differentiation of the ST-segment depression of acute myocardial injury due to the left circumflex artery occlusion from that of myocardial ischemia of nonocclusive etiologies\u003c/strong\u003e. \u003cem\u003eThe American journal of cardiology \u003c/em\u003e1997, \u003cstrong\u003e80\u003c/strong\u003e(4):512-513.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Antoni ML, Yiu K-H, Atary JZ, Delgado V, Holman ER, van der Wall EE, Schuijf JD, Bax JJ, Schalij MJ: \u003cstrong\u003eDistribution of culprit lesions in patients with ST-segment elevation acute myocardial infarction treated with primary percutaneous coronary intervention\u003c/strong\u003e. \u003cem\u003eCoronary artery disease \u003c/em\u003e2011, \u003cstrong\u003e22\u003c/strong\u003e(8):533-536.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Valente S, Lazzeri C, Chiostri M, Giglioli C, Zucchini M, Grossi F, Gensini GF: \u003cstrong\u003eGender-related difference in ST-elevation myocardial infarction treated with primary angioplasty: a single-centre 6-year registry\u003c/strong\u003e. \u003cem\u003eEuropean journal of preventive cardiology \u003c/em\u003e2012, \u003cstrong\u003e19\u003c/strong\u003e(2):233-240.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Antoniucci D, Valenti R, Moschi G, Migliorini A, Trapani M, Santoro GM, Bolognese L, Dovellini EV: \u003cstrong\u003eSex-based differences in clinical and angiographic outcomes after primary angioplasty or stenting for acute myocardial infarction\u003c/strong\u003e. \u003cem\u003eThe American journal of cardiology \u003c/em\u003e2001, \u003cstrong\u003e87\u003c/strong\u003e(3):289-293.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Zimmerman FH, Cameron A, Fisher LD, Grace N: \u003cstrong\u003eMyocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry)\u003c/strong\u003e. \u003cem\u003eJournal of the American College of Cardiology \u003c/em\u003e1995, \u003cstrong\u003e26\u003c/strong\u003e(3):654-661.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Mukherjee D, Hsu A, Moliterno DJ, Lincoff AM, Goormastic M, Topol EJ: \u003cstrong\u003eRisk factors for premature coronary artery disease and determinants of adverse outcomes after revascularization in patients\u0026le; 40 years old\u003c/strong\u003e. \u003cem\u003eThe American journal of cardiology \u003c/em\u003e2003, \u003cstrong\u003e92\u003c/strong\u003e(12):1465-1467.\u003c/li\u003e\n \u003cli dir=\"LTR\"\u003e Bhardwaj R, Kandoria A, Sharma R: \u003cstrong\u003eMyocardial infarction in young adults-risk factors and pattern of coronary artery involvement\u003c/strong\u003e. \u003cem\u003eNigerian medical journal: journal of the Nigeria Medical Association \u003c/em\u003e2014, \u003cstrong\u003e55\u003c/strong\u003e(1):44.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1. Demographic information and comorbidities\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable dir=\"rtl\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e12.7\u0026plusmn;59.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eAge (mean\u0026plusmn;SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%78.9)396\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%33.7)164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eFH\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%26.7)131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eDM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%41.6)204\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eHTN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%23.3)114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eDyslipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(18.2%)88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eCKD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%40.7)198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent smoker\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%27.5)133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003ePrior IHD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%4)20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003ePrior CABG\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%4.9)24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003ePrior Stroke\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(%16.8)82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eOpium addiction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e11.08\u0026plusmn;40.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eEjection Fraction (mean\u0026plusmn;SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e(%6.3)28\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eMortality (in hospital)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e88.2\u0026plusmn;88.71\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eFMC to PCI Time (min)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e193.3\u0026plusmn;250.84\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eTotal ischemic time (min)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e(45.6%)226\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eAnterior STEMI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e(26.4%)131\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eInferior STEMI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e(18.3%)91\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003ePosterior STEMI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e(9.7%)48\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"50%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eNo-STEMI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 2. Risk factor prevalence across different infarct-related arteries\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable dir=\"\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eRCA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eLCX\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eLAD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e0.01\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e(72.9%)114\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e(66.2%)45\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e(83.3%)189\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.79381443298969%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e(20.8%)30\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.855670103092784%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e(33.8%)23\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.5979381443299%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003e\u003cspan dir=\"RTL\"\u003e(16.7%)38\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.75257731958763%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e0.196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e(33.6%)48\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e(44.8%)30\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e(33.2%)73\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eFH\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e0.743\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(28.7%)41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(23.9%)16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(26.1%)58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eDM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e0.338\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(43.4%)62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(49.3%)33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(39.4%)87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eHTN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e0.783\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(25.2%)36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(20.9%)14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(23.2%)51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eDyslipidemia\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e0.99\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(17.4%)25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(17.9%)12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(17.4%)38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eCKD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e0.38\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(51%)73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(44.8%)30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(54.3%)119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eCurrent smoker\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e0.66\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(23.1%)33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(19.4%)13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(24.5%)54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003eOpium\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e0.87\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(24.6%)35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(27.7%18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(24.7%)54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003ePrior IHD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.30116472545757%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003e\u003cspan dir=\"RTL\"\u003e0.443\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.973377703826955%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(3.5%)5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.63727121464226%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(7.5%)5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.46422628951747%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e(4.5%)10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.62396006655574%\" valign=\"top\"\u003e\n \u003cp dir=\"LTR\"\u003ePrior Stroke\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Coronary angiography, Coronary artery disease, Myocardial infarction","lastPublishedDoi":"10.21203/rs.3.rs-4155722/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4155722/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Coronary artery disease (CAD) is one of the most common causes of mortality worldwide. Several studies have demonstrated that some areas of the coronary arteries are more prone to thrombosis. This study investigated the associations between angiographic findings and risk factors for coronary artery disease.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: This cross-sectional study investigated the total number of patients with ST-elevation myocardial infarction (STEMI) referred to the angiography department at Hazrat-E-Rasool Hospital from 21st March 2017 to 20th March 2018. All patients underwent standard coronary angiography; if necessary, a stent was deployed in the infarct-related artery (IRA). The referrals were made through emergency medical services (EMS) or the hospital's emergency department.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Fifty-two patients were enrolled as STEMI patients and underwent coronary angiography at Hazrat-E-Rasool Hospital in 1396. The mean age of the patients was 59.7±12.7 years, and 78.9% were males. The most frequently involved vessels were the left anterior descending (LAD), right coronary artery (RCA), and left circumflex(LCX) Most lesions in the LAD were located in the mid-segment, while in the RCA and LCX, the involvement predominantly occurred in the proximal segment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: The results of our study demonstrated that the LAD artery is the most commonly involved vessel. Additionally, male sex, family history, and smoking are considered risk factors at a younger age, while diabetes, hypertension, and chronic kidney disease (CKD) play significant roles in older generations.\u003c/p\u003e","manuscriptTitle":"Coronary angiographic findings and clinical characteristics in patients with ST-elevation myocardial infarction: A cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-11 11:12:58","doi":"10.21203/rs.3.rs-4155722/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4b5feaaf-3f4a-4dce-9b0f-2c00b958b299","owner":[],"postedDate":"April 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-07-10T09:17:31+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-11 11:12:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4155722","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4155722","identity":"rs-4155722","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}