Clinical characteristics of acute non-ST-segment elevation myocardial infarction patients with total occlusion of infarct-related artery

Objective To investigate the clinical characteristics of acute non-ST-segment elevation myocardial infarction(NSTEMI) patients with total occlusion of infarct-related artery(IRA). Methods Consecutive 42 patients who had confirmed diagnosis of acute NSTEMI and experienced total occlusion of IRA detected by emergency angiography within 24 hours from the heart attack were enrolled.The clinical characteristics of these patients were stndied.Results In the patients whose IRA was circumflex artery,the proportion of good collateral circulation was lower compared with the patients whose IRA was anterior descending branch or right coronary artery(P0.05).In the patients with IRA being circumflex artery,the proportion of cases whose symptoms were persistent and were not alleviated before angiography was greater compared with other patients(P0.05).The proportion of patients with IRAs being right coronary artery,whose symptoms were not chest pain,was greater than the other patients(P0.05).Conclusion If classification was according to different IRAs,the acute NSTEMI patients with total occlusion of IRA have different characteristics.The total occlusion of circumflex artery which is apt to be missed by the standard ECG is worthy of attention.