A Retrospective Clinical Analysis of 216 Patients With Non-ST Segment Elevation Myocardial Infarction

• 来源期刊: 岭南心血管病杂志（英文版）
• 关键词: non-ST segment elevation myocardial infarction retrospective analysis
• 年，卷（期）: 2008,（3）
• 页码范围: 107-115
• 页数: 9页
• 语种: 英文

摘要

Objectives To analyze the clinical characteristics of 216 patients with non-ST segment elevation myocardial infarc-tion (NSTEMI). Methods A retrospective analysis was used. Two hundred and sixteen NSTEMI patients were divid-ed into two groups: ①according to the age: age <65 years group and age ≥65 years group; ② according to throm-bolysis in myocardial ischemia trial (TIMI) IIB risk stratification scoring system: score <4 group and ≥4 group; ③ according to serum creatinine (sCr) level: sCr level ≤178 μmol· L-1group and > 178 μmol. L-1 group. Seven hundred and eighty six acute myocardial infarction (AMI) patients during the same period were divided into ST seg-ment elevation myocardial infarction (STEMI) group and NSTEMI group. Clinical characteristics of the patients in th e two groups were compared. Results ① The number of NSTEMI patients in age ≥65 years group is significantly grea-ter than that in age < 65 years group. Study revealed that the patients in age ≥65 years group were without chest pain,had hypertension, dyslipidemia, atrial fibrillation, cardiac and renal dysfunction (sCr > 178 μmol· L-1) and triple ves-sel disease. Fewer patients in this group received coronary artery angiography (CAG), percutaneous coronary interven-tion (PCI) and coronary artery bypass graft (CABG). More number of deaths in this group compared with the age < 65 years group. ② The number of NSTEMI patients in TIMI score > 4 group is significantly greater than that in TIMI score < 4 group. Four major complications such as acute left ventricular failure, cardiogenic shock, serious arrhythmia and deaths, increased significantly in TIMI score >4 group comparing with TIMI score ≤4 group. ③ Obviously, more number of elderly patients, non-insulin dependant diabetes mellitus (NIDDM), patients with cardiac troponin T (CTnT) >3.0 ng · L-1 and deaths occurred in sCr > 178 μmol · L-1 group. @ STEMI and NSTEMI patients were compared in same time frame as follows: fewer NSTEMI patients and more elderly patients had no chest pain, NID-DM, hypertension, dyslipidemia, left main coronary artery (LMCA) disease while CTnT ≥3.0 ng· ml-1; fewer pa- tients with aneurysm (30 days) underwent CAG, PCI and CABG treatment. However, there were no significant differ-ences in smokers, patients with less than 50% stenosis in any vessel, 1 -3 vessel disease, acute left ventricle heart fail-ure, cardiogenic shock, serious arrhythmia and deaths. ⑤ The multivariate logistic regression analysis showed that death in NSTEMI was directly influenced by malignant arrhythmias with age ≥ 70 years. Conclusions Patients with NSTEMI were older, had more risk factors and presented more serious vessel disease, therefore, less of them could re-ceive standard treatment. Complications and mortality of patients with NSTEMI were similar to that of patients with STEMI. Thus, NSTEMI is a serious disease with poor prognosis. NSTEMI patients may present with atypical chest pain and electrocardiogram changes, so are easily missed or loss diagnosed.