This preprint is under consideration at BMC Cardiovascular Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Impact of Acute Total Occlusion of Culprit Artery on Outcome in NSTEMI – Results From a Large National Registry
Marek Rajzer
Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Kraków, Poland
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The impact of acute total occlusion (TO) of culprit artery in non-ST-segment elevation myocardial infarction (NSTEMI) is not fully established. We aimed to evaluate clinical and angiographic phenotype and outcome of NSTEMI patients with TO (NSTEMITO) compared to NSTEMI patients without TO (NSTEMINTO) and those with ST-segment elevation and TO (STEMITO).
Methods
Demographic, clinical and procedure-related data of patients with percutaneous coronary intervention (PCI) performed in acute myocardial infarction between 2014 and 2017 from the Polish National Registry were analysed.
Results
We evaluated 131,729 patients: NSTEMINTO (n=65,206), NSTEMITO (n=16,209) and STEMITO (n=50,314). NSTEMITO group had intermediate results compared to NSTEMINTO and STEMITO regarding: mean age (68.78±11.39 vs 65.98±11.61 vs 64.86±12.04 (years), p<0.0001), Killip class IV on admission (1.69 vs 2.48 vs 5.03(%), p<0.0001), cardiac arrest before admission (2.19 vs 3.09 vs 6.02(%), p<0.0001) and death during PCI (0.43 vs 0.97 vs 1.76(%), p<0.0001) - for NSTEMINTO, NSTEMITO and STEMITO, respectively. However, in NSTEMITO we noticed: the longest time from pain to first medical contact (median 4.0 vs 5.0 vs 2.0 (hours), p<0.0001); left circumflex artery (LCx) most often as culprit lesion (14.09 vs 35.86 vs 25.42(%), p<0.0001) and lowest frequency of TIMI flow grade 3 after PCI (88.61 vs 83.36 vs 95.57(%), p<0.0001).
Conclusions
NSTEMITO clearly differs from NSTEMINTO. It appears as an intermediate condition between NSTEMINTO and STEMITO, although NSTEMITO patients have the longest time delay to and the worst result of PCI which can be explained by the location of the culprit lesion in LCx.
Keywords
myocardial infarction, STEMI, NSTEMI, coronary angiography, total artery occlusion
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- Visualsummary.jpg
Visual summary. Approximately one-fifth of NSTEMI patients has acute occlusion of coronary artery, predominantly left circumflex artery; time delay to revascularization in this group is significantly extended and PCI outcome worse.
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 06 Jan, 2021
No community comments so far
Reviewer #2 agreed
On 09 Jan, 2021
Reviewer #4 agreed
On 09 Jan, 2021
Reviewer #3 agreed
On 09 Jan, 2021
Reviewer #1 agreed
On 09 Jan, 2021
Reviewers invited
Invitations sent on 05 Jan, 2021
Editor assigned
On 05 Jan, 2021
Editor invited
On 05 Jan, 2021
Submission checks complete
On 05 Jan, 2021
First submitted
On 02 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Learn more about our company.
This preprint is under consideration at BMC Cardiovascular Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Impact of Acute Total Occlusion of Culprit Artery on Outcome in NSTEMI – Results From a Large National Registry
Marek Rajzer
Jagiellonian University Medical College, 1st Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Kraków, Poland
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 06 Jan, 2021
No community comments so far
Reviewer #2 agreed
On 09 Jan, 2021
Reviewer #4 agreed
On 09 Jan, 2021
Reviewer #3 agreed
On 09 Jan, 2021
Reviewer #1 agreed
On 09 Jan, 2021
Reviewers invited
Invitations sent on 05 Jan, 2021
Editor assigned
On 05 Jan, 2021
Editor invited
On 05 Jan, 2021
Submission checks complete
On 05 Jan, 2021
First submitted
On 02 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The impact of acute total occlusion (TO) of culprit artery in non-ST-segment elevation myocardial infarction (NSTEMI) is not fully established. We aimed to evaluate clinical and angiographic phenotype and outcome of NSTEMI patients with TO (NSTEMITO) compared to NSTEMI patients without TO (NSTEMINTO) and those with ST-segment elevation and TO (STEMITO).
Methods
Demographic, clinical and procedure-related data of patients with percutaneous coronary intervention (PCI) performed in acute myocardial infarction between 2014 and 2017 from the Polish National Registry were analysed.
Results
We evaluated 131,729 patients: NSTEMINTO (n=65,206), NSTEMITO (n=16,209) and STEMITO (n=50,314). NSTEMITO group had intermediate results compared to NSTEMINTO and STEMITO regarding: mean age (68.78±11.39 vs 65.98±11.61 vs 64.86±12.04 (years), p<0.0001), Killip class IV on admission (1.69 vs 2.48 vs 5.03(%), p<0.0001), cardiac arrest before admission (2.19 vs 3.09 vs 6.02(%), p<0.0001) and death during PCI (0.43 vs 0.97 vs 1.76(%), p<0.0001) - for NSTEMINTO, NSTEMITO and STEMITO, respectively. However, in NSTEMITO we noticed: the longest time from pain to first medical contact (median 4.0 vs 5.0 vs 2.0 (hours), p<0.0001); left circumflex artery (LCx) most often as culprit lesion (14.09 vs 35.86 vs 25.42(%), p<0.0001) and lowest frequency of TIMI flow grade 3 after PCI (88.61 vs 83.36 vs 95.57(%), p<0.0001).
Conclusions
NSTEMITO clearly differs from NSTEMINTO. It appears as an intermediate condition between NSTEMINTO and STEMITO, although NSTEMITO patients have the longest time delay to and the worst result of PCI which can be explained by the location of the culprit lesion in LCx.
Figure 1
Figure 2
Figure 3