In:
BMC Cardiovascular Disorders, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
Abstract:
The impact of acute total occlusion (TO) of the culprit artery in non-ST-segment elevation myocardial infarction (NSTEMI) is not fully established. We aimed to evaluate the clinical and angiographic phenotype and outcome of NSTEMI patients with TO (NSTEMI TO ) compared to NSTEMI patients without TO (NSTEMI NTO ) and those with ST-segment elevation and TO (STEMI TO ). Methods Demographic, clinical and procedure-related data of patients with acute myocardial infarction who underwent percutaneous coronary intervention (PCI) between 2014 and 2017 from the Polish National Registry were analysed. Results We evaluated 131,729 patients: NSTEMI NTO (n = 65,206), NSTEMI TO (n = 16,209) and STEMI TO (n = 50,314). The NSTEMI TO group had intermediate results compared to the NSTEMI NTO and STEMI TO groups regarding mean age (68.78 ± 11.39 vs 65.98 ± 11.61 vs 64.86 ± 12.04 (years), p 〈 0.0001), Killip class IV on admission (1.69 vs 2.48 vs 5.03 (%), p 〈 0.0001), cardiac arrest before admission (2.19 vs 3.09 vs 6.02 (%), p 〈 0.0001) and death during PCI (0.43 vs 0.97 vs 1.76 (%), p 〈 0.0001)—for NSTEMI NTO , NSTEMI TO and STEMI TO , respectively. However, we noticed that the NSTEMI TO group had the longest time from pain to first medical contact (median 4.0 vs 5.0 vs 2.0 (hours), p 〈 0.0001) and the lowest frequency of TIMI flow grade 3 after PCI (88.61 vs 83.36 vs 95.57 (%), p 〈 0.0001) and that the left circumflex artery (LCx) was most often the culprit lesion (14.09 vs 35.86 vs 25.42 (%), p 〈 0.0001). Conclusions The NSTEMI TO group clearly differed from the NSTEMI NTO group. NSTEMI TO appears to be an intermediate condition between NSTEMI NTO and STEMI TO , although NSTEMI TO patients have the longest time delay to and the worst result of PCI, which can be explained by the location of the culprit lesion in the LCx.
Type of Medium:
Online Resource
ISSN:
1471-2261
DOI:
10.1186/s12872-021-02099-y
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2021
detail.hit.zdb_id:
2059859-2
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