Department of Cardiovascular and Renal Medicine, Hyogo College of Medicine, Hyogo, Japan.
Clin Cardiol. 2021 Feb;44(2):238-243. doi: 10.1002/clc.23534. Epub 2020 Dec 28.
Patients with non-ST-elevation myocardial infarction (NSTEMI) have worse long-term prognoses than those with ST-elevation myocardial infarction (STEMI).
It may be attributable to more extended coronary atherosclerotic disease burden in patients with NSTEMI.
This study consisted of consecutive 231 patients who underwent coronary intervention for myocardial infarction (MI). To assess the extent and severity of atherosclerotic disease burden of non-culprit coronary arteries, two scoring systems (Gensini score and synergy between percutaneous coronary intervention with Taxus and cardiac surgery [SYNTAX] score) were modified by subtracting the score of the culprit lesion: the non-culprit Gensini score and the non-culprit SYNTAX score.
Patients with NSTEMI had more multi-vessel disease, initial thrombolysis in myocardial infarction (TIMI) flow grade 2/3, and final TIMI flow grade 3 than those with STEMI. As compared to STEMI, patients with NSTEMI had significantly higher non-culprit Gensini score (16.3 ± 19.8 vs. 31.2 ± 25.4, p < 0.001) and non-culprit SYNTAX score (5.8 ± 7.0 vs. 11.1 ± 9.7, p < 0.001).
Patients with NSTEMI had more advanced coronary atherosclerotic disease burden including non-obstruction lesions, which may at least in part explain higher incidence of cardiovascular events in these patients.
非 ST 段抬高型心肌梗死（NSTEMI）患者的长期预后比 ST 段抬高型心肌梗死（STEMI）患者差。
这可能归因于 NSTEMI 患者的冠状动脉粥样硬化病变负担更广泛。
本研究纳入了 231 例因心肌梗死（MI）而行冠状动脉介入治疗的连续患者。为了评估非罪犯冠状动脉粥样硬化病变负担的程度和严重程度，我们对两种评分系统（Gensini 评分和经皮冠状动脉介入治疗与紫杉醇协同作用评分系统[SYNTAX]评分）进行了修改，方法是减去罪犯病变的评分：非罪犯 Gensini 评分和非罪犯 SYNTAX 评分。
与 STEMI 患者相比，NSTEMI 患者多支血管病变、初始心肌梗死溶栓治疗（TIMI）血流分级 2/3 和最终 TIMI 血流分级 3 的比例更高。与 STEMI 相比，NSTEMI 患者的非罪犯 Gensini 评分（16.3±19.8 比 31.2±25.4，p<0.001）和非罪犯 SYNTAX 评分（5.8±7.0 比 11.1±9.7，p<0.001）显著更高。
NSTEMI 患者的冠状动脉粥样硬化病变负担更重，包括非阻塞性病变，这至少部分解释了这些患者心血管事件发生率较高的原因。
