Incidence of total coronary occlusion and its influence on prognosis in patients with non-ST-segment elevation myocardial infarction
Zhu Hongtao
Liu Xueqing
Rui Limei
Zhang Youming
Ding Xiaojun
Zhao Jianfeng
Li Binyi
Qiu Linlin
Abstract：observe the distribution of the total occlusion of culprit vessels and its influence on prognosis in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Methods NSTEMI patients (n=192) were chosen from Department of Cardiology in People’s Hospital of Danyang City from Jan. 2014 to Dec. 2017. All patients were divided, according to flow grading of thrombolysis in myocardial infarction (TIMI), into total occlusion group (TIMI=0, n=30), and non-total occlusion group (TIMI=1-3, n=162). The incidence and distribution of total coronary occlusion were analyzed in NSTEMI patients. The incidence rates of sudden cardiac death, recurrent nonfatal myocardial infarction (MI), target vessel revascularization (TVR) and stroke were reviewed in 2 groups during hospitalization and after discharged from hospital for 30 d, 90 d and 180 d. Results Among 192 patients, 30 (15.6%) with total occlusion of culprit vessels, 5 (16.7%) with total occlusion of left anterior descending branch coronary artery, 14 (46.7%) with total occlusion of left circumflex of coronary artery, and 11 (36.7%) with total occlusion of right coronary artery. Compared with non-total occlusion group, the age was younger, the level of low-density lipoprotein-cholesterol (LDL-C) was higher and TIMI integral was higher at hospitalization time in total occlusion group (P<0.05). The results of binary regression analysis showed that only TIMI integral at hospitalization time (OR=2.699, 95%CI:1.283~5.674, P=0.009) and LDL-C (OR=1.994, 95%CI:1.263~3.148, P=0.003) were the independent predictive factors for the total occlusion of culprit vessels. The incidence of major composite endpoint events was higher in total occlusion group during hospitalization and after discharged from hospital for 30 d, but there was no statistical difference between 2 groups after discharged from hospital for 180 d. Conclusion There are 30 (15.6%) NSTEMI patients with the total occlusion of culprit vessels, and there is no significant difference in major composite endpoint events between 2 groups after discharged from hospital for 180 d. TIMI integral at hospitalization time and LDL-C level can be taken as the independent predictive factors for total coronary occlusion of coronary artery.
Keywords：Non-ST-segment elevation myocardial infarctionTotal coronary occlusionSudden cardiac deathNonfatal myocardial infarctionTarget vessel revascularization
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1197-1200 )