Frequency and Determinants of Three-Vessel Coronary Artery Disease in Diabetic Patients Presenting With Non-ST Segment Elevation Myocardial Infarction at a Tertiary Cardiac Center

Objectives: This study aimed to determine the frequency of three-vessel coronary artery disease (3VD) among diabetic patients presenting with non-ST segment elevation myocardial infarction (NSTEMI) and to identify demographic and clinical factors associated with multivessel coronary involvement. Methodology: A cross-sectional analysis was conducted at the National Institute of Cardiovascular Diseases (NICVD), Karachi, from July 2021 to January 2022. A total of 170 diabetic NSTEMI patients were enrolled through consecutive sampling. Demographic profiles, cardiovascular risk factors, and clinical characteristics were recorded. Coronary angiography was performed and independently reviewed to categorize triple-vessel involvement. Data were analyzed using SPSS v21, with associations evaluated via Chi-square or Fisher’s exact tests and significance set at p ≤ 0.05. Results: The mean age of participants was 56.4 ± 8.99 years, and 85.9% were male. The prevalence of 3VD was 28.8%. Significant associations were found between 3VD and gender (p < 0.001), smoking status (p = 0.004), and urban residence (p = 0.002). No significant associations were observed with hypertension (p = 0.951), BMI, dyslipidemia, or duration of diabetes (p = 0.757). Female patients showed disproportionately higher angiographic severity, with 70.8% demonstrating 3VD. Conclusion: Nearly one-third of diabetic patients with NSTEMI exhibited triple-vessel involvement, with gender, smoking status, and urban residence emerging as significant factors. These findings emphasize the need for early invasive evaluation and targeted risk-factor management in diabetic NSTEMI populations.