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Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction

Journal of Biomedicine and Translational Research · Vol. 7 No. 1 (2021) · hlm. 30–37

DOI
10.14710/jbtr.v7i1.10693
ISSN
2503-2178
Terbit
2021-04-30
Penerbit
Faculty of Medicine, Universitas Diponegoro
Bahasa
eng

Abstrak

Background: Double coronary culprit lesions in ST-segment elevation myocardial infarction (STEMI) is uncommon. Despite successful primary percutaneous coronary intervention (PPCI) in all culprit lesions, the clinical outcome remains unfavorable and the possible factors for the outcome are not fully understood.Cases Presentation: We reported four cases of double culprit lesions STEMI underwent PPCI. Patient A, a 62 y.o. male with extensive anterior-inferior STEMI, had total occlusion (TO) at both proximal left anterior descending (LAD) and mid right coronary artery (RCA). Patient B, a 42 y.o. male with extensive anterior-inferior STEMI, had subtotal occlusion (STO) at proximal RCA and TO at proximal LAD. Both of them had RBBB ECG pattern. Patient C, a 67 y.o. male with inferior STEMI had 90% thrombus occlusion at proximal–mid LAD and TO at proximal RCA. Patient D, a 65 y.o. male with anteroseptal STEMI, had STO at proximal LAD and 80% thrombus occlusion at mid left circumflex. The cardiomyocyte infarction biomarkers increased in all patients. Although all of them underwent successful PPCI in all of culprit lesions, they suffered from acute heart failure and two of them experienced recurrent ventricular arrhythmia episodes. One of them (patient A) died two days post PPCI. He was only patient who suffering from total occlusion in LAD and RCA with TIMI thrombus 5 and experienced a total atrioventricular block post-PPCI.Conclusion: STEMI with coronary double culprits have severe clinical outcome, regardless of the successful PCI. The degree of coronary occlusions might be linked to the patient clinical outcome.

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  • Diponegoro University
  • Dr. Kariadi Hospital
  • Tottori University
  • Sultan Agung Islamic University
  • Toranomon Hospital
  • Rumah Sakit Umum Pusat Dr. Sardjito
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Rekan penulisOrganisasiArtikel bersama
Nani MaharaniDiponegoro University3
A SidiekDiponegoro University3
Ardi YudhaDiponegoro University1
Sultana MH FaradzDiponegoro University1
Hery Djagat PurnomoDiponegoro University1
Rayvita AN MeagratiaDiponegoro University1
Ferdy Kurniawan CayamiDiponegoro University1
Wiwik LestariDiponegoro University1
Fikri TaufiqSultan Agung Islamic University1
Ichiro HisatomeTottori University1
Peili LiTottori University1
Masanari KuwabaraToranomon Hospital1
Haruaki NinomiyaTottori University1
Yan Wisnu PrajokoDiponegoro University1
Nyoman Suci WidyastitiDiponegoro University1
Qorry AmandaDiponegoro University1
Reza Maulana MunandarDiponegoro University1
Susi HerminingsihDiponegoro University1
Putrika Prastuti Ratna GhariniRumah Sakit Umum Pusat Dr. Sardjito1
Mochamad Ali SobirinDiponegoro University1

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Sumber metadata: OAI-PMH (metadata jurnal) https://ejournal2.undip.ac.id/index.php/jbtr/oai, pertama di-harvest 9 Nov 2026, terakhir terlihat 9 Nov 2026.
Metadata asli (oai_dc) 
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	<dc:title xml:lang="en-US">Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction</dc:title>
	<dc:creator>Uddin, Ilham</dc:creator>
	<dc:creator>Wardhani, Anindia</dc:creator>
	<dc:creator>Cahyadi, Misbah Hari</dc:creator>
	<dc:creator>Puspitasari, Desy Ayu</dc:creator>
	<dc:creator>Ardhianto, Pipin</dc:creator>
	<dc:creator>Bahrudin, Udin</dc:creator>
	<dc:creator>Herry, Yan</dc:creator>
	<dc:creator>Rifqi, Sodiqur</dc:creator>
	<dc:subject xml:lang="en-US">ST-segment elevation myocardial infarction; double coronary artery culprits; clinical out-come; degree of coro-nary occlusion</dc:subject>
	<dc:description xml:lang="en-US">Background: Double coronary culprit lesions in ST-segment elevation myocardial infarction (STEMI) is uncommon. Despite successful primary percutaneous coronary intervention (PPCI) in all culprit lesions, the clinical outcome remains unfavorable and the possible factors for the outcome are not fully understood.Cases Presentation: We reported four cases of double culprit lesions STEMI underwent PPCI. Patient A, a 62 y.o. male with extensive anterior-inferior STEMI, had total occlusion (TO) at both proximal left anterior descending (LAD) and mid right coronary artery (RCA). Patient B, a 42 y.o. male with extensive anterior-inferior STEMI, had subtotal occlusion (STO) at proximal RCA and TO at proximal LAD. Both of them had RBBB ECG pattern. Patient C, a 67 y.o. male with inferior STEMI had 90% thrombus occlusion at proximal–mid LAD and TO at proximal RCA. Patient D, a 65 y.o. male with anteroseptal STEMI, had STO at proximal LAD and 80% thrombus occlusion at mid left circumflex. The cardiomyocyte infarction biomarkers increased in all patients. Although all of them underwent successful PPCI in all of culprit lesions, they suffered from acute heart failure and two of them experienced recurrent ventricular arrhythmia episodes. One of them (patient A) died two days post PPCI. He was only patient who suffering from total occlusion in LAD and RCA with TIMI thrombus 5 and experienced a total atrioventricular block post-PPCI.Conclusion: STEMI with coronary double culprits have severe clinical outcome, regardless of the successful PCI. The degree of coronary occlusions might be linked to the patient clinical outcome. </dc:description>
	<dc:publisher xml:lang="en-US">Faculty of Medicine, Universitas Diponegoro</dc:publisher>
	<dc:date>2021-04-30</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US"></dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://ejournal2.undip.ac.id/index.php/jbtr/article/view/10693</dc:identifier>
	<dc:identifier>10.14710/jbtr.v7i1.10693</dc:identifier>
	<dc:source xml:lang="en-US">Journal of Biomedicine and Translational Research; Vol 7, No 1 (2021): April 2021; 30-37</dc:source>
	<dc:source>2503-2178</dc:source>
	<dc:source>10.14710/jbtr.v7i1</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>https://ejournal2.undip.ac.id/index.php/jbtr/article/view/10693/5443</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2021 Journal of Biomedicine and Translational Research</dc:rights>
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