Frequency of Non-ST Segment Elevation Myocardial Infarction (NSTEMI) in Acute Coronary Syndrome Patients with Normal Electrocardiograms: A Study from a Tertiary Care Hospital in Peshawar

Abstract

This study aimed to determine the frequency of Non-ST Segment Elevation Myocardial Infarction (NSTEMI) among patients presenting with acute coronary syndrome (ACS) and normal electrocardiograms (ECGs) at a tertiary care hospital in Peshawar.A cross-sectional study conducted at the Department of Cardiology, Khyber Teaching Hospital, Peshawar.The research was carried out from October 24, 2021, to April 24, 2022. 106 patients, ages 25 to 60, who had ACS but a normal ECG at admission were included in the study. Individuals with cardiomyopathy, valvular heart disease, or ST-segment elevation were not included. To find NSTEMI cases, clinical and demographic information was gathered, and cardiac troponin I levels were assessed. IBM SPSS version 23 was used for statistical analysis, and the chi-square test for stratified data was used, with a significance threshold of p ≤ 0.05. The mean age of participants was 52.73 ± 14.24 years, and 66% were male. The frequency of NSTEMI in ACS patients with a normal ECG was 26.4%. Other significant findings included a mean BMI of 28.3 ± 5.2 kg/m² and an average symptom duration of 15.40 ± 8.72 hours. The study found a notable prevalence of NSTEMI among ACS patients with normal ECGs, emphasizing that a normal ECG should not rule out myocardial infarction. Comprehensive clinical evaluation and cardiac biomarkers are essential for accurate diagnosis.