1Assistant Professor & HOD (i/c), Department of Forensic Medicine and Toxicology, Tripura Medical College & Dr. BRAM Teaching Hospital, Hapania, Agartala, Tripura-799014
2Senior Resident, Department of Paediatrics, Agartala Government Medical College & GBP Hospital, Kunjaban, Agartala, Tripura-799005
3Assistant Professor, Department of General Surgery, Tripura Medical College & Dr. BRAM Teaching Hospital, Hapania, Agartala, Tripura-799014
4Medical Officer, Grade-III of Tripura Health Services, Department of Health & Family Welfare, Government of Tripura-799014
5Assistant Professor, Department of Physiology, Agartala Government Medical College & GBP Hospital, Kunjaban, Agartala, Tripura-799005
Acute myocardial infarction (AMI) remains a global health burden. Early identification of individuals at high risk, particularly those with ≥70% coronary artery stenosis, can facilitate preventive strategies. This systematic review and meta-analysis aimed to evaluate the risk of AMI among patients with critical coronary artery narrowing.
A comprehensive literature search of PubMed, Scopus, Embase, and Cochrane Library was conducted for studies published from January 2000 to December 2023. Eligible studies included adults (≥18 years) with angiographically confirmed ≥70% stenosis in at least one major coronary artery and reported AMI incidence. Data were extracted and pooled using a random-effects model. Heterogeneity was assessed using the I2 statistic, and risk of bias was evaluated with the Newcastle-Ottawa Scale and the Cochrane RoB tool. PROSPERO Registration: CRD420251075342.
Eighteen studies (n=22,456 participants) were included. The pooled relative risk (RR) of developing AMI in patients with ≥70% stenosis was 3.45 (95% CI: 2.88–4.13), with moderate heterogeneity (I2 = 48%). Subgroup analysis showed higher risk among patients with multi-vessel disease and diabetics. Funnel plot and Egger’s test (p=0.22) showed no significant publication bias.
Patients with critical coronary stenosis are at substantially elevated risk for subsequent AMI. These findings emphasize the need for vigilant monitoring, risk stratification, and aggressive therapeutic interventions in this high-risk cohort. Future studies should focus on novel biomarkers and predictive models to enhance early detection.
Acute myocardial infarction, Coronary stenosis, Critical narrowing, Prediction, Meta-analysis
