Early predictors of severe left main and/or three‐vessel disease in patients with non‐ST‐segment elevation myocardial infarction: A dual‐center retrospective study

Abstract

Abstract Background Early detection of patients concomitant with left main and/or three‐vessel disease (LM/3VD) and high SYNTAX score (SS) is crucial for determining the most effective revascularization options regarding the use of antiplatelet medications and prognosis risk stratification. However, there is a lack of study for predictors of LM/3VD with SS in patients with non‐ST‐segment elevation myocardial infarction (NSTEMI). We aimed to identify potential factors that could predict LM/3VD with high SS (SS > 22) in patients with NSTEMI. Methods This dual‐center retrospective study included a total of 481 patients diagnosed with NSTEMI who performed coronary angiography procedures. Clinical factors on admission were collected. The patients were divided into non‐LM/3VD, Nonsevere LM/3VD (SS ≤ 22), and Severe LM/3VD (SS > 22) groups. To identify independent predictors, Univariate and logistic regression analyses were conducted on the clinical parameters. Results A total of 481 patients were included, with an average age of 60.9 years and 75.9% being male. Among these patients, 108 individuals had severe LM/3VD. Based on the findings of a multivariate logistic regression analysis, the extent of ST‐segment elevation observed in lead aVR (OR: 7.431, 95% CI: 3.862–14.301, p < .001) and age (OR: 1.050, 95% CI: 1.029–1.071, p < .001) were identified as independent predictors of severe LM/3VD. Conclusion This study indicated that the age of patients and the extent of ST‐segment elevation observed in lead aVR on initial electrocardiogram were the independent predictive factors of LM/3VD with high SS in patients with NSTEMI.

Keywords

• aVR
• left main and/or three‐vessel disease (LM/3VD)
• non‐ST‐segment elevation myocardial infarction (NSTEMI)
• predictor
• SYNTAX score (SS)