ArticleThe Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology2021
Incidence and impact of totally occluded culprit coronary artery in patients with non-ST segment elevation myocardial infarction acute coronary syndrome.
Article in The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 18 citations in OpenAlex.
- Long-Term Outcomes in NSTEMI Patients Based on Coronary TIMI Flow State on Presentation.Journal of clinical medicine · 2026Article
- Clinical and Electrocardiographic Characteristics in NSTEMI Patients With Acute Total Occlusion of Culprit Left Circumflex Artery.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2025Article
- Reevaluating STEMI: The Utility of the Occlusive Myocardial Infarction Classification to Enhance Management of Acute Coronary Syndromes.Current cardiology reports · 2025Review
- Angiographic findings in patients with Non-ST-elevation myocardial infarction.Pakistan journal of medical sciences · 2024Article
- Article
- Clinical decision-making in patients with non-ST-segment-elevation myocardial infarction: more than risk stratification.Frontiers in cardiovascular medicine · 2024Article
- Long-term clinical outcomes in patients with non-ST-segment Elevation Acute Coronary Syndrome and ST-segment elevation myocardial infarction with thrombolysis in myocardial infarction 0 flow.International journal of cardiology. Heart & vasculature · 2023Article
- From Q/Non-Q Myocardial Infarction to STEMI/NSTEMI: Why It's Time to Consider Another Simplified Dichotomy; a Narrative Literature Review.Archives of academic emergency medicine · 2022Review
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5 authors at 1 institution in 1 country.
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Abstract
backgroundSignificance of totally occluded culprit coronary artery in patients presenting with non-ST segment elevation myocardial infarction (NSTEMI) is underestimated. The aim of the study was to evaluate the incidence and impact of totally occluded culprit artery on in-hospital and 6 months follow-up outcomes of NSTEMI acute coronary syndrome (ACS) patients.
resultsWe collected retrospectively data of 500 NSTEMI patients who presented to our hospital from June 2016 to June 2017. All patients underwent PCI within 72 h of presentation. We excluded patients with cardiogenic shock, prior CABG, and STEMI. Patients were divided into two groups according to pre-procedural culprit vessel thrombolysis in myocardial infarction (TIMI) flow. Group 1, TIMI flow 0 total coronary occlusion, included 112 patients (22.4%). Group 2, TIMI flow 1-3 non-total occlusion, included 388 patients (77.6%). Group 1 patients had significantly higher incidence of smoking (p=0.01), significantly higher level of cardiac enzymes (p<0.001), significantly more collaterals (p<0.001), and significantly more LCX and RCA as the culprit vessel (p<0.01), while group 2 patients had significantly higher incidence of diabetes (p=0.02) and significantly more LAD as the culprit vessel. There were no significant differences between the two groups regarding the major adverse cardiac and cerebrovascular events (MACCE) in-hospital (5.3% in totally occluded group vs. 1% in non-totally occluded group, p=0.07), but group 1 patients had significantly higher incidence of in-hospital arrhythmia (8.9% in group 1 vs. 1% in group 2, p=0.007). After 6 months follow-up, there were no significant differences regarding MACCE between the 2 groups after 6 months follow-up (5.4% in group 1 vs. 4.6% of group 2, P=0.24).
conclusion22.4% of NSTEMI patients have a totally occluded culprit artery. The presence of an occluded culprit artery did not significantly affect the clinical outcomes of NSTEMI patients either in-hospital or after 6 months follow-up but was associated with significantly higher incidence of in-hospital arrhythmia.
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