The Heart Research Center of Chonnam National University Hospital, Gwangju, Korea.
Korean Circ J. 2009 Aug;39(8):297-303. doi: 10.4070/kcj.2009.39.8.297. Epub 2009 Aug 27.
In Korea, the incidence of acute myocardial infarction has been increasing rapidly. Twelve-month clinical outcomes for 13,133 patients with acute myocardial infarction enrolled in the nationwide prospective Korea Acute Myocardial Infarction Registry study were analyzed according to the presence or absence of ST-segment elevation. Patients with ST-segment elevation myocardial infarction (STEMI) were younger, more likely to be men and smokers, and had poorer left ventricular function with a higher incidence of cardiac death compared to patients with non-ST-segment elevation myocardial infarction (NSTEMI). NSTEMI patients had a higher prevalence of 3-vessel and left main coronary artery disease with complex lesions, and were more likely to have co-morbidities. The in-hospital and 1-month survival rates were higher in NSTEMI patients than in STEMI patients. However, 12-month survival rates was not different between the two groups. In conclusion, NSTEMI patients have worse clinical outcomes than STEMI patients, and therefore should be treated more intensively during clinical follow-up.
在韩国,急性心肌梗死的发病率迅速上升。根据是否存在 ST 段抬高,对全国前瞻性韩国急性心肌梗死注册研究中纳入的 13133 例急性心肌梗死患者的 12 个月临床结局进行了分析。ST 段抬高型心肌梗死(STEMI)患者较非 ST 段抬高型心肌梗死(NSTEMI)患者更年轻、更可能为男性和吸烟者,左心室功能更差,心脏死亡发生率更高。与 NSTEMI 患者相比,NSTEMI 患者更易发生三支血管和左主干病变,且病变更复杂,更易合并并存疾病。NSTEMI 患者的住院和 1 个月生存率高于 STEMI 患者。然而,两组患者 12 个月的生存率无差异。总之,NSTEMI 患者的临床结局比 STEMI 患者差,因此在临床随访期间应更积极地治疗。