Acute coronary syndrome in a tertiary care setting: Clinical characteristics, inflammatory profiles, and determinants of cardiogenic shock

ABSTRACT Objective: To compare the clinical, electrocardiographic, and biochemical characteristics of ST-elevation myocardial infarction (STEMI) and non-ST-elevation acute coronary syndrome (NSTE-ACS) and to evaluate factors associated with cardiogenic shock (CS). Materials and Methods: In this prospective observational study, 105 consecutive patients aged 18-80 years with acute coronary syndrome, admitted to a tertiary care center (June 2024–May 2025) were classified as STEMI ( n = 42) or NSTE-ACS ( n = 63; non-ST-elevation myocardial infarction = 48, unstable angina = 15). Clinical, electrocardiogram, and laboratory data were recorded at admission. Results: The mean age was 58 ± 10.8 years, and 74% were male. STEMI was associated with a higher incidence of CS (29% vs. 3%, P < 0.01) and lower left ventricular ejection fraction (median: 42.5% vs. 47.5%, P = 0.04) compared with NSTE-ACS. STEMI patients had higher levels of D-dimer, procalcitonin, creatine kinase-myocardial band, and neutrophil counts (all P < 0.05), consistent with greater thrombotic and inflammatory activity. CS occured more frequently in patients with diabetes (79% vs. 35%, P < 0.01) and in females (50% vs. 22%, P = 0.05). Conclusions: STEMI is associated with greater inflammatory and thrombotic activation and a higher risk of CS than NSTE-ACS. Diabetes was associated with an increased occurrence of CS. These findings require confirmation in larger studies.