Among patients presenting with NSTEMI, 33.66% had occlusion myocardial infarction on early angiography, for which ECG indicators showed low sensitivity (41.17%) and specificity (68.65%).
Observational (n=101)
No
What is the prevalence of occlusion myocardial infarction (OMI) in patients presenting with NSTEMI, and how well do ECG findings correlate with angiographic results?
A significant proportion (33.66%) of NSTEMI patients have total coronary occlusion (OMI) on early angiography, which is poorly detected by standard ECG criteria.
Abstract Background: The existing ST-segment elevation myocardial infarction (STEMI)-non-ST-STEMI (NSTEMI) classification often overlooks patients with total occlusion who do not meet the STEMI criteria on electrocardiography (ECG). This study primarily examines patients who initially presented with NSTEMI but were found to have a total occlusion upon early angiography, and explores the correlation between their ECG findings and the angiographic results. Materials and Methods: This is a prospective observational study carried out in the Department of Medicine at JIPMER from April 2023 to June 2024. The study involved patients admitted with a diagnosis of NSTEMI in either the medicine or cardiology departments. Following a comprehensive clinical examination, patients underwent angiography, and the proportion of patients with total occlusion was determined. In addition, their ECG findings were correlated. Results: 33.66% of patients were diagnosed with occlusion myocardial infarction (OMI) based on coronary angiography within 96 h. The majority were male (79.4%) with an average age of 55.15 years. Of the 34 OMI patients, 41.2% showed ECG indicators, but the sensitivity and specificity were 41.17% and 68.65%, respectively. The most common vessel affected by total OMI was the right coronary artery (RCA; 41.2%), followed by the left circumflex artery (LCx; 26.5%), with the inferolateral wall being most often involved. Intervention occurred in 20.58% of OMI patients and 32.83% of non-OMI patients. Conclusion: The study found a significant number of acute coronary syndrome-NSTEMI patients with OMI, where elevated troponin levels were more common. The RCA and LCx were the most frequently affected vessels, with the inferolateral wall often involved. ECG indicators showed low sensitivity and specificity for detecting OMI.
Singh et al. (Fri,) conducted a observational in Non-ST-segment Elevation Myocardial Infarction (NSTEMI) (n=101). Early coronary angiography and ECG correlation was evaluated on Proportion of patients with total occlusion (OMI) and correlation with ECG findings. Among patients presenting with NSTEMI, 33.66% had occlusion myocardial infarction on early angiography, for which ECG indicators showed low sensitivity (41.17%) and specificity (68.65%).