Prevalence and Risk Factors of Wellens Syndrome in Patients with Acute Coronary Syndrome

Abstract Background Wellens syndrome complicates acute coronary syndrome and, if unmanaged, can lead to immanent myocardial infarction. This study aimed towards determining the prevalence of Wellens syndrome among acute coronary syndrome patients while focusing on both types and identifying the most associated risk factor, then determining the commonest coronary artery affected in those who fulfilled Wellens syndrome criteria. Methods Implementing a descriptive cross sectional hospital based observational study design at Ahmed Gasim Teaching Hospital for Cardiac Surgery and Renal Transplantation in Khartoum North, Sudan, the study was conducted using a non probability convenience sampling of patients fitting the inclusion criteria. Data was collected using closed ended structured questionnaires. Ethical clearance was obtained from relevant authorities. Data analysis was done using descriptive and comparative data analysis with the aid of the SPSS software. Results A total of 120 patients were included, 70 males and 50 females, majority in their fifth decade. 14 patients had no documented risk factors. 42.5% had STEMI, 34.2% had NSTEMI and 23.3% had unstable angina. Patients fulfilling Wellens syndrome criteria were 18 (15%), 44.4% of them were type A and 55.6 were type B. Specific prevalence among NSTEMI alone was 29.3% and 21.4% among unstable angina alone. Most frequently encountered risk factor among Wellens syndrome patients was Diabetes (50%). Out of 16 Wellens syndrome patients who underwent coronary angiography, 50% had mid LAD involvement, most were of type B; 25% had proximal LAD involvement and 25% had normal coronary angiography. There was significant association between Wellens syndrome and NSTEMI, but no significant association with any specific risk factor. Conclusion Wellens syndrome is not a rare condition although uncommon, it can present even without a specific predisposing risk factor and coronary angiographic variation other than the proximal part of the LAD artery may occur.