Comparison of coronary artery lesions and ventricular performance for non-ST-segment and ST-segment elevation myocardial infarction

Objective To compare the characteristics of coronary artery lesions and ventricular systolic, diastolic and synchronous function of non-ST-segment elevation (NSTEMI) with those of ST-segment elevation myocardial infarction (STEMI) in Chinese. Methods One hundred and sixty-eight consecutive patients with NSTEMI 116 and STEMI 52 were enrolled into this study. Coronary angiography (CAG) was performed within 72 hours in all patients, while the parameters of left ventricular function were measured by equilibrium radionuclide angiography (ERNA) with ventricular phase analysis (PA) within 1 week after acute myocardial infarction. Results (1) The incidences of patients associated with diabetes and old myocardial infarction in NSTEMI group were higher than those in STEMI group (30.77% vs 10.34%; 34.62% P0.01), respectively, but the incidence of patients associated with heart failure was lower in NSTEMI group. The incidence of angina pectoris before AMI in NSTEMI group was higher than that in STEMI group (61.54% vs 24.14%, P0.01). The peak values of CK and CK-MB in NSTEMI group were reduced by 55.33% and 58.60% (P0.05) as compared with those in STEMI group, individually. (2) The incidences of multi-vessel lesions, 90%-99% stenosis, C-type lesions, TIMI-Ⅲ-grade of collateral circulation and TIMI-Ⅲ-grade of IRA in NSTEMI group were higher than those in STEMI group (P0.05), respectively,but the incidence of acute ventricular aneurysm was lower in NSTEMI group than that in STEMI group (3.85% vs 23.28%, P0.01). (3) The parameter of ventricular diastolic function PFR in NSTEMI group was decreased by 7.36% (P0.01) and TPFR was increased by 4.75% (P0.01) as compared with those in STEMI group. The parameters of ventricular systolic synchrony (VSS) PS, FWHM and PSD in NSTEMI group were reduced by 15.05%, 15.84% and 27.04% (P0.01) as compared with those in STEMI group, individually. Conclusion The incidence of complex multi-vessel lesions in NSTEMI was higher and the damage of diastolic function was more significant than those in STEMI; the incidences of total occlusion of IRA and acute ventricular aneurysm with reduction of VSS in STEMI were higher than those in NSTEMI.