Comparison of angiographic and other findings and mortality in nonST-segment elevation versus ST-segment elevation myocardial infarction in patients undergoing early invasive intervention

Young Bin Song, Joo Yong Hahn, Ju Han Kim, Sang Yeup Lee, Soo Hee Choi, Jin Ho Choi, Seung Hyuk Choi, Sang Hoon Lee, Junghan Yoon, Young Jo Kim, Myung Ho Jeong, Hyeon Cheol Gwon

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Abstract

We sought to compare the angiographic findings and mortality in patients with nonST-segment elevation (NSTEMI) versus ST-segment elevation myocardial infarction (STEMI) undergoing early invasive intervention. Of 11,872 patients enrolled in the Korean Acute Myocardial Infarction Registry from November 2005 to January 2008, we studied patients with NSTEMI undergoing early invasive intervention (n = 1,486) and those with STEMI undergoing primary percutaneous coronary intervention (n = 4,392). Multivessel coronary disease, baseline Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, and the left circumflex artery as a culprit lesion occurred more frequently in patients with NSTEMI than in those with STEMI. Those with NSTEMI had a significantly lower mortality rate than those with STEMI during a median follow-up of about 12 months (3.8% vs 6.7%, p <0.001). In the patients with NSTEMI, the independent predictors of mortality included postprocedural TIMI flow grade 0 to 2 (hazard ratio [HR] 3.07, 95% confidence interval [CI] 1.01 to 9.29, p = 0.047) and multivessel coronary disease (HR 3.83, 95% CI 1.36 to 10.81, p = 0.010) but not baseline TIMI flow or infarct location. However, baseline TIMI flow grade 0 to 2 (HR 1.56, 95% CI 1.03 to 2.36, p = 0.035), anterior infarction (HR 1.69, 95% CI 1.28 to 2.23, p <0.001), multivessel coronary disease (HR 1.45, 95% CI 1.10 to 1.91, p = 0.008), and postprocedural TIMI flow grade 0 to 2 (HR 2.00, 95% CI 1.42 to 2.82, p <0.001) were all independent predictors of mortality in the patients with STEMI. In conclusion, the angiographic findings in patients from NSTEMI differ from those in patients with STEMI. Postprocedural TIMI flow and multivessel coronary disease were independent predictors of mortality in patients with NSTEMI undergoing early invasive intervention.

Original languageEnglish
Pages (from-to)1397-1403
Number of pages7
JournalAmerican Journal of Cardiology
Volume106
Issue number10
DOIs
Publication statusPublished - 2010 Nov 15

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Myocardial Infarction
Mortality
Confidence Intervals
Coronary Disease
ST Elevation Myocardial Infarction
Percutaneous Coronary Intervention
Non-ST Elevated Myocardial Infarction
Infarction
Registries
Arteries

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Song, Young Bin ; Hahn, Joo Yong ; Kim, Ju Han ; Lee, Sang Yeup ; Choi, Soo Hee ; Choi, Jin Ho ; Choi, Seung Hyuk ; Lee, Sang Hoon ; Yoon, Junghan ; Kim, Young Jo ; Jeong, Myung Ho ; Gwon, Hyeon Cheol. / Comparison of angiographic and other findings and mortality in nonST-segment elevation versus ST-segment elevation myocardial infarction in patients undergoing early invasive intervention. In: American Journal of Cardiology. 2010 ; Vol. 106, No. 10. pp. 1397-1403.
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abstract = "We sought to compare the angiographic findings and mortality in patients with nonST-segment elevation (NSTEMI) versus ST-segment elevation myocardial infarction (STEMI) undergoing early invasive intervention. Of 11,872 patients enrolled in the Korean Acute Myocardial Infarction Registry from November 2005 to January 2008, we studied patients with NSTEMI undergoing early invasive intervention (n = 1,486) and those with STEMI undergoing primary percutaneous coronary intervention (n = 4,392). Multivessel coronary disease, baseline Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, and the left circumflex artery as a culprit lesion occurred more frequently in patients with NSTEMI than in those with STEMI. Those with NSTEMI had a significantly lower mortality rate than those with STEMI during a median follow-up of about 12 months (3.8{\%} vs 6.7{\%}, p <0.001). In the patients with NSTEMI, the independent predictors of mortality included postprocedural TIMI flow grade 0 to 2 (hazard ratio [HR] 3.07, 95{\%} confidence interval [CI] 1.01 to 9.29, p = 0.047) and multivessel coronary disease (HR 3.83, 95{\%} CI 1.36 to 10.81, p = 0.010) but not baseline TIMI flow or infarct location. However, baseline TIMI flow grade 0 to 2 (HR 1.56, 95{\%} CI 1.03 to 2.36, p = 0.035), anterior infarction (HR 1.69, 95{\%} CI 1.28 to 2.23, p <0.001), multivessel coronary disease (HR 1.45, 95{\%} CI 1.10 to 1.91, p = 0.008), and postprocedural TIMI flow grade 0 to 2 (HR 2.00, 95{\%} CI 1.42 to 2.82, p <0.001) were all independent predictors of mortality in the patients with STEMI. In conclusion, the angiographic findings in patients from NSTEMI differ from those in patients with STEMI. Postprocedural TIMI flow and multivessel coronary disease were independent predictors of mortality in patients with NSTEMI undergoing early invasive intervention.",
author = "Song, {Young Bin} and Hahn, {Joo Yong} and Kim, {Ju Han} and Lee, {Sang Yeup} and Choi, {Soo Hee} and Choi, {Jin Ho} and Choi, {Seung Hyuk} and Lee, {Sang Hoon} and Junghan Yoon and Kim, {Young Jo} and Jeong, {Myung Ho} and Gwon, {Hyeon Cheol}",
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Comparison of angiographic and other findings and mortality in nonST-segment elevation versus ST-segment elevation myocardial infarction in patients undergoing early invasive intervention. / Song, Young Bin; Hahn, Joo Yong; Kim, Ju Han; Lee, Sang Yeup; Choi, Soo Hee; Choi, Jin Ho; Choi, Seung Hyuk; Lee, Sang Hoon; Yoon, Junghan; Kim, Young Jo; Jeong, Myung Ho; Gwon, Hyeon Cheol.

In: American Journal of Cardiology, Vol. 106, No. 10, 15.11.2010, p. 1397-1403.

Research output: Contribution to journalArticle

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T1 - Comparison of angiographic and other findings and mortality in nonST-segment elevation versus ST-segment elevation myocardial infarction in patients undergoing early invasive intervention

AU - Song, Young Bin

AU - Hahn, Joo Yong

AU - Kim, Ju Han

AU - Lee, Sang Yeup

AU - Choi, Soo Hee

AU - Choi, Jin Ho

AU - Choi, Seung Hyuk

AU - Lee, Sang Hoon

AU - Yoon, Junghan

AU - Kim, Young Jo

AU - Jeong, Myung Ho

AU - Gwon, Hyeon Cheol

PY - 2010/11/15

Y1 - 2010/11/15

N2 - We sought to compare the angiographic findings and mortality in patients with nonST-segment elevation (NSTEMI) versus ST-segment elevation myocardial infarction (STEMI) undergoing early invasive intervention. Of 11,872 patients enrolled in the Korean Acute Myocardial Infarction Registry from November 2005 to January 2008, we studied patients with NSTEMI undergoing early invasive intervention (n = 1,486) and those with STEMI undergoing primary percutaneous coronary intervention (n = 4,392). Multivessel coronary disease, baseline Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, and the left circumflex artery as a culprit lesion occurred more frequently in patients with NSTEMI than in those with STEMI. Those with NSTEMI had a significantly lower mortality rate than those with STEMI during a median follow-up of about 12 months (3.8% vs 6.7%, p <0.001). In the patients with NSTEMI, the independent predictors of mortality included postprocedural TIMI flow grade 0 to 2 (hazard ratio [HR] 3.07, 95% confidence interval [CI] 1.01 to 9.29, p = 0.047) and multivessel coronary disease (HR 3.83, 95% CI 1.36 to 10.81, p = 0.010) but not baseline TIMI flow or infarct location. However, baseline TIMI flow grade 0 to 2 (HR 1.56, 95% CI 1.03 to 2.36, p = 0.035), anterior infarction (HR 1.69, 95% CI 1.28 to 2.23, p <0.001), multivessel coronary disease (HR 1.45, 95% CI 1.10 to 1.91, p = 0.008), and postprocedural TIMI flow grade 0 to 2 (HR 2.00, 95% CI 1.42 to 2.82, p <0.001) were all independent predictors of mortality in the patients with STEMI. In conclusion, the angiographic findings in patients from NSTEMI differ from those in patients with STEMI. Postprocedural TIMI flow and multivessel coronary disease were independent predictors of mortality in patients with NSTEMI undergoing early invasive intervention.

AB - We sought to compare the angiographic findings and mortality in patients with nonST-segment elevation (NSTEMI) versus ST-segment elevation myocardial infarction (STEMI) undergoing early invasive intervention. Of 11,872 patients enrolled in the Korean Acute Myocardial Infarction Registry from November 2005 to January 2008, we studied patients with NSTEMI undergoing early invasive intervention (n = 1,486) and those with STEMI undergoing primary percutaneous coronary intervention (n = 4,392). Multivessel coronary disease, baseline Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, and the left circumflex artery as a culprit lesion occurred more frequently in patients with NSTEMI than in those with STEMI. Those with NSTEMI had a significantly lower mortality rate than those with STEMI during a median follow-up of about 12 months (3.8% vs 6.7%, p <0.001). In the patients with NSTEMI, the independent predictors of mortality included postprocedural TIMI flow grade 0 to 2 (hazard ratio [HR] 3.07, 95% confidence interval [CI] 1.01 to 9.29, p = 0.047) and multivessel coronary disease (HR 3.83, 95% CI 1.36 to 10.81, p = 0.010) but not baseline TIMI flow or infarct location. However, baseline TIMI flow grade 0 to 2 (HR 1.56, 95% CI 1.03 to 2.36, p = 0.035), anterior infarction (HR 1.69, 95% CI 1.28 to 2.23, p <0.001), multivessel coronary disease (HR 1.45, 95% CI 1.10 to 1.91, p = 0.008), and postprocedural TIMI flow grade 0 to 2 (HR 2.00, 95% CI 1.42 to 2.82, p <0.001) were all independent predictors of mortality in the patients with STEMI. In conclusion, the angiographic findings in patients from NSTEMI differ from those in patients with STEMI. Postprocedural TIMI flow and multivessel coronary disease were independent predictors of mortality in patients with NSTEMI undergoing early invasive intervention.

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