Comparison of Short-Term Outcomes of Occlusive and Non-Occlusive Non-ST Elevation Myocardial Infarction

Authors

  • Asfandyar Ashraf Department of Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Muhammad Nadir Khan Department of Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Muhammad Husnain Yousaf Department of Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Hira Zakria Department of Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Nouman Hameed Department of Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Javeria Kamran Department of Research & Development, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74iSUPPL-1.11850

Keywords:

Non-Occlusive Myocardial Infarction, Non-ST Elevation Myocardial Infarction, Occlusive Myocardial Infarction, Outcome

Abstract

Objective: To compare the short-term outcomes of patients with Occlusive Myocardial Infarction and Non-occlusive Myocardial Infarction in the context of non-ST Elevation Myocardial Infarction.

Study Design: Analytical Cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan; from 15 Jul to 15 Nov 2023.

Methodology: One hundred and ninety four patients aged 20 to 75 years with NSTEMI were consecutively enrolled. Patients were classified into OMI and NOMI groups using angiographic, laboratory tests and electrocardiographic findings. Short-term outcomes such as stroke, heart failure, recurrent myocardial infarction, and mortality were recorded. The comparative analysis assessed differences in baseline characteristics and clinical endpoints between Occlusive Myocardial Infarction and Non-occlusive Myocardial Infarction patients. Chi square test was applied to compare the categorical variables among study groups and p-value <0.05 was considered as statistically significant.

Results: Among 194 patients, there were 71(36.6%) patients with Occlusive Myocardial Infarction & 123(63.4%) with Non-occlusive Myocardial Infarction and mean age was 60.68 ±12.97 years. Majority of the patients presented with Triple Vessel Coronary Artery Disease 89(45.9%), followed by Single and Double Vessel Coronary Artery Disease [60(30.9%); 45(23.2%)] respectively. Short-term outcomes included heart failure 50(25.8%), stroke 4(2.1%), recurrent MI 8(4.1%), and death 7(3.6%). However, the difference was not significant among study groups (p>0.05). In OMI ...

Conclusion: The study emphasizes tailored management strategies for NSTEMI patient....

Downloads

Download data is not yet available.

References

Shao C, Wang J, Tian J, Tang YD. Coronary Artery Disease: From Mechanism to Clinical Practice. Adv Exp Med Biol. 2020; 1177:1-36. https://doi.org/10.1007/978-981-15-2517-9_1.

Malakar AK, Choudhury D, Halder B, Paul P, Uddin A, Chakraborty S. A review on coronary artery disease, its risk factors, and therapeutics. J Cell Physiol. 2019 Aug; 234(10): 16812-16823. https://doi.org/10.1002/jcp.28350.

Gaziano TA, Bitton A, Anand S, Abrahams-Gessel S, Murphy A. Growing epidemic of coronary heart disease in low- and middle-income countries. Curr Probl Cardiol. 2010; 35(2): 72–115. https://doi.org/10.1016/j.cpcardiol.2009.10.002.

Hertz JT, Kweka GL, Bloomfield GS, Limkakeng AT Jr, Loring Z, Temu G, et al. Patterns of Emergency Care for Possible Acute Coronary Syndrome Among Patients with Chest Pain or Shortness of Breath at a Tanzanian Referral Hospital. Glob Heart. 2020; 15(1): 9. https://doi.org/10.5334/gh.402.

Awan A, Ogunti R, Fatima U, Gonzalez H, Ganta N, Rizwan M, et al. Timing of Percutaneous Coronary Intervention in Non-ST Elevation Acute Coronary Syndrome - Meta-Analysis and Systematic Review of Literature. Cardiovasc Revasc Med. 2020; 21(11): 1398-1404. https://doi.org/10.1016/j.carrev.2019.10.004.

Mitsis A, Gragnano F. Myocardial Infarction with and without ST-segment Elevation: a Contemporary Reappraisal of Similarities and Differences. Curr Cardiol Rev. 2021; 17(4): e230421189013. https://doi.org/10.2174/1573403X16999201210195702.

Lambert LJ, Brophy JM, Racine N, Rinfret S, L'Allier PL, Brown KA, et al. Outcomes of Patients With ST-Elevation Myocardial Infarction Receiving and Not Receiving Reperfusion Therapy:

The Importance of Examining All Patients. Can J Cardiol. 2016; 32(11): 1325.e11-1325.e18.

https://doi.org/10.1016/j.cjca.2016.02.073.

Rodríguez-Padial L, Fernández-Pérez C, Bernal JL, Anguita M, Sambola A, Fernández-Ortiz A, et al. Differences in in-hospital mortality after STEMI versus NSTEMI by sex. Eleven-year trend in the Spanish National Health Service. Rev Esp Cardiol (Engl Ed). 2021; 74(6): 510-517. English, Spanish.

https://doi.org/10.1016/j.rec.2020.04.017.

Kos N, Zeljković I, Krčmar T, Golubić K, Šaler F, Erceg M, et al. Acute Occlusion of the Infarct-Related Artery as a Predictor of Very Long-Term Mortality in Patients with Acute Myocardial Infarction. Cardiol Res Pract. 2021; 2021: 6647626.

https://doi.org/10.1155/2021/6647626.

Jayachandra A, Datta R, Swamy A, Issar NK, Sarkar S, Aggarwal V. Profile of acute coronary syndromes in serving personnel presenting to a field cardiology center without cath lab facilities. J Mar Med Soc. 2022 Jul 1; 24(2): 176-9.

https://doi.org/10.4103/jmms.jmms_40_22

Faramand Z, Helman S, Ahmad A, Martin-Gill C, Callaway C, Saba S, et al. Performance and limitations of automated ECG interpretation statements in patients with suspected acute coronary syndrome. J Electrocardiol. 2021; 69S: 45-50.

https://doi.org/10.1016/j.jelectrocard.2021.08.014.

Zègre-Hemsey JK, Hogg M, Crandell J, Pelter MM, Gettes L, Chung EH, et al. Prehospital ECG with ST-depression and T-wave inversion are associated with new onset heart failure in individuals transported by ambulance for suspected acute coronary syndrome. J Electrocardiol. 2021; 69S: 23-28.

https://doi.org/10.1016/j.jelectrocard.2021.08.005.

Fakhri Y, Andersson H, Gregg RE, Babaeizadeh S, Kastrup J, Holmvang L, et al. Diagnostic performance of a new ECG algorithm for reducing false positive cases in patients suspected acute coronary syndrome. J Electrocardiol. 2021 Nov-Dec; 69: 60-64. https://doi.org/10.1016/j.jelectrocard.2021.07.005.

Hwang HJ, Park CB, Cho JM, Jin ES, Sohn IS, Kim DH, et al. Clinical characteristics of occluded culprit arteries and collaterals in patients with non-ST-segment elevation myocardial infarction and impact on clinical outcomes. Exp Ther Med. 2018 Oct; 16(4): 3710-3720.

https://doi.org/10.3892/etm.2018.6605.

Karwowski J, Gierlotka M, Gąsior M, Poloński L, Ciszewski J, Bęćkowski M, et al. Relationship between infarct artery location, acute total coronary occlusion, and mortality in STEMI and NSTEMI patients. Pol Arch Intern Med. 2017; 127(6): 401-411. https://doi.org/10.20452/pamw.4018.

Avdikos G, Michas G, Smith SW. From Q/Non-Q Myocardial Infarction to STEMI/NSTEMI: Why It's Time to Consider Another Simplified Dichotomy; a Narrative Literature Review. Arch Acad Emerg Med. 2022; 10(1): e78.

https://doi.org/10.22037/aaem.v10i1.1783.

Hung CS, Chen YH, Huang CC, Lin MS, Yeh CF, Li HY, et al. Prevalence and outcome of patients with non-ST segment elevation myocardial infarction with occluded "culprit" artery - a systemic review and meta-analysis. Crit Care. 2018; 22(1): 34.

https://doi.org/10.1186/s13054-018-1944-x.

Aslanger EK, Yıldırımtürk Ö, Şimşek B, Bozbeyoğlu E, Şimşek MA, Yücel Karabay C, et al. Diagnostic accuracy of electro-cardiogram for acute coronary occlusion resulting in myocardial infarction (DIFOCCULT Study). Int J Cardiol Heart Vasc. 2020 Jul 30; 30: 100603. https://doi.org/10.1016/j.ijcha.2020.100603.

Downloads

Published

30-05-2024

Issue

Section

Original Articles

How to Cite

1.
Ashraf A, Khan MN, Yousaf MH, Zakria H, Hameed N, Kamran J. Comparison of Short-Term Outcomes of Occlusive and Non-Occlusive Non-ST Elevation Myocardial Infarction. Pak Armed Forces Med J [Internet]. 2024 May 30 [cited 2024 Nov. 19];74(SUPPL-1):S48-S53. Available from: https://pafmj.org/PAFMJ/article/view/11850