Comparison of clinical and angiographic characteristics of acute ST-segment elevation and non-ST-segment elevation myocardial infarction

Zhang Ning; Liu Wenxian; Pan Lili

doi:10.3760/cma.j.issn.1673-4777.2016.04.001

Abstract：Objective To compare the clinical and angiographic presentation of acute ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI).Methods The clinical data of 622 patients with acute myocardial infarction from June 2013 to August 2014,including 417 cases of STEMI (STEMI group) and 205 cases of NSTEMI (NSTEMI group) were retrospectively analyzed.The general data,accessory examination result and in-hospital mortality were compared between groups.Results The age,proportions of hypertension and diabetes were significantly older/higher,the proportion of smoking was significantly lower in NSTEMI group than those in STEMI group [(58 ± 11) years vs (56 ± 11) years,62.4％ (128/205) vs 54.7％ (228/417),29.8％ (61/205) vs 23.0％ (96/417),54.6％ (112/205) vs 65.2％ (272/417)] (P ＜ 0.05).The systolic pressure,serum creatinine,B-type natriuretic peptide and glycosylated hemoglobin in NSTEMI group were significantly higher than those in STEMI group [(126 ± 19) mmHg vs (120 ± 19) mmHg,(84 ±24) μmol/L vs (80 ±41) μmol/L,191 (65,551) ng/L vs 164 (60,487) ng/L,(6.8 ± 1.7) ％ vs (6.6 ± 3.5) ％],the leukocyte count,myocardial markers [creatine kinase (CK),CK-MB and cardiac troponin Ⅰ] and left ventricular ejection fraction in NSTEMI group were significantly lower than those in STEMI group [7.38 (6.22,9.03) × 109/L vs 9.17 (7.32,11.33) × 109/L,121 (65,226) U/Lvs568 (114,2 134) U/L,3.20 (1.45,9.00) U/L vs 59.50 (3.75,233.85) U/L,1.72 (0.48,5.68) μg/L vs 11.72 (0.88,66.47) μg/L,(55± 11)％ vs (61 ±17)％] (P＜0.05).The proportions of one,two and three-vessel diseases was 47.7％ (199/417),32.4％ (135/417),19.9％ (83/417) in STEMI group and 35.1％ (72/205),35.1％ (72/205),29.8％ (61/205) in NSTEMI group;the proportions of one and three-vessel diseases were significantly different between groups (P ＜0.05).Three-vessel diseases was risk factor of NSTEMI (odds ratio 2.031,confidence interval:1.326-3.112,P =0.010).The in-hospital mortality was not significantly different between groups [1.0％ (4/417) vs 2.4％ (5/205),P =0.164].Conclusions Patients with NSTEMI have higher proportion of three-vessel diseases compared with patients with STEMI;they are often combined with heart and renal dysfunction,with higher blood pressure,glucose level and serum creatinine;while the in-hospital mortality of NSTEMI were as the same as NSTEMI.