Non-invasive predictors & clinical outcomes of Non ST Elevation myocardial infarction (NSTEMI) with completely occluded coronary artery (OCA)

Document Type : Original Article

Authors

1 Cardiology specialist ,Gamal Abd el naser insurance hospital,Alexandria

2 Cardiology department, Faculty of medicine, Zagazig university, Egypt

3 Cardiology Department , Faculty of medicine , Zagazig University , Zagazig , Egypt

4 Cardiology department,Faculty of medicine ,Zagazig,Egypt.

Abstract

Background: TIMI score has been used to predict outcomes in patients presenting with NSTEMI with occluded coronary artery .
Objective: To assess the independent predictors & clinical outcomes of patient with – NSTEMI with occluded coronary artery .
Methods: A prospective cohort of 100 patients presented with NSTEMI with occluded coronary artery from December 2018 to May 2019 in Cardiology Department, Zagazig University Hospitals and Gamal Abdel-Naser Health Insurance Hospital were recruited. Patients were divided into two groups: group (A): patients with NSTEMI with non-occluded artery and group (B): patients with NSTEMI with occluded artery. Patients underwent PCI during admission. We analyzed the demographic, angiographic data and potential risk predictors for major adverse cardiac events (MACE) and death during in hospital follow up.
Results: Patients with totally occluded lesion were statistically significant younger in age (mean age in years 56.9 ± 8.6) versus (mean age in years 62.4 ± 11.1) in patients with patent vessel, more smoking (seventeen patients, 77.3%) versus (thirty-five patients, 44.9%) in patients with patent culprit vessel. Patients with totally occluded culprit vessel had higher incidence of MACE during hospital stay (six patients, 27.3%) versus (seven patients, 9%) in patients with patent culprit vessel and higher Recurrent ischemic symptoms and decompensated HF.
Conclusion: A quarter of NSTEMI patients had an occluded coronary artery. They were more likely to be affected by smoking with high troponin and CK-MB. were more prone to MACE.

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