Clinical characteristics and prognosis in patients with non-ST-segment elevation myocardial infarction and coronary total occlusion
ZHENG Wei
LIU Fangfang
ZHENG Botao
Abstract：Objective To investigate the characteristics of coronary total occlusion(CTO)and their predictive value to major adverse cardiovascular events(MACE)in patients with non-ST-segment elevation myocardial infarction(NSTEMI).Methods NSTEMI patients(n=197)were retrospectively analyzed in Department of Cardiology of Shanxi Bethune Hospital from Nov.2017 to Nov.2022.All patients were divided,according to whether or not acute thrombotic occlusion occurrence,into occlusion group and non-occlusion group.The clinical characteristics,laboratory indicators and prognosis were compared between 2 groups.The independent risk factors of CTO and MACE were analyzed and screened by applied Logistic regression analysis.Results A total 197 NSTEMI patients included,male accounted for 79.2%,and average age was(59.32±12.96).The incidence of acute thrombotic occlusion was 14.72%.The results of multivariate analysis showed that smoking history(OR=5.893,95%CI:1.715～20.246,P=0.005),and increased low-density lipoprotein-cholesterol(LDL-C,OR=1.693,95%CI:1.120～2.561,P=0.013),high sensitivity cardiac troponin T(hs-cTnT,OR=1.003,95%CI:1.001-1.005,P=0.002),brain natriuretic peptide(BNP,OR=1.002,95%CI:1.000～1.003,P=0.035)and soluble growth stimulation expressed gene 2(sST2,OR=1.024,95%CI:1.007～1.043,P=0.007)were independent risk factors for acute thrombotic occlusion.The incidence of MACE was 21.83%,and its independent risk factors were drinking history(OR=3.516,95%CI:1.118～11.057,P=0.031),and increased LDL-C(OR=1.881,95%CI:1.201～2.946,P=0.006),hs-cTnI(OR=1.007,95%CI:1.004～1.010,P<0.001),BNP(OR=1.004,95%CI:1.002-1.006,P<0.001)and sST2(OR=1.025,95%CI:1.002～1.048,P=0.034).In addition,age(OR=1.081,95%CI:1.031-1.134,P=0.001),smoking history(OR=2.321,95%CI:1.176-4.580,P=0.015)and hypertension history(OR=2.045,95%CI:1.163-3.598,P=0.013)were independent risk factors for number of lesion coronary vessels.Conclusion Smoking,dyslipidemia and elevated myocardial injury biomarkers(hs-cTnI,BNP,ST2)are closely related to acute thrombotic occlusion and MACE in NSTEMI patients.Elderly patients with hypertension are more prone to developing multi-vessel coronary artery disease,and it is necessary to strengthen early identification and intervention measures to improve prognosis.
Keywords：non-ST-segment elevation myocardial infarctionocclusion of coronary arterymajor adverse cardiovascular eventsnumber of lesion coronary vessels
Publication Date：2025-12-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：6( 1512-1517 )