Acta Medica Leopoliensia (Dec 2016)
The relation of various clinical and instrumental parameters to the character of coronary arteries lesions in patients with myocardial infarction without ST-elevation
Abstract
Aim. To determine the correlation links between clinical and instrumental parameters with the character of coronary arteries lesions in patients with myocardial infarction without ST-elevation. Material and Methods. We observed 40 patients (62.5% men) with Non-ST-segment elevation myocardial infarction (NSTEMI) aged from 52 to 79 (average of 67,1±1,4) years during 2011-2015 years. All patients underwent coronary angiography on SIEMENS Axiom Artis (Germany) in 1 to 70 (average 19,4±3,0) hours with after admission . All patients were examined according to the protocol of treatment of myocardial infarction by Association of cardiologists of Ukraine (2009) using all accredited clinical, laboratory, and instrumental parameters. Statistic data processing was conducted with unparametric methods of variation statistics. Significance of differences between the quantitative parameters was counted by Mann-Whitney U test; between the qualitative parameters - by c2 criteria. Presence of interactions between indicators was determined by Spearman Rank Order Correlations. Results and Discussion. Anatomic lesions of two coronary arteries were determined in 52,5%, and hemodynamically significant stenosis of both coronary arteries - in 30,0% of patients. Hemodynamically significant stenosis of three coronary arteries was registered only in 5,0% of cases. Our data do not support findings from other studies indicating the presence of intact coronary vessels in 20-30% of patients and easier anatomical coronary artery disease in women, unlike men, in different age groups and in different forms of acute coronary syndrome, which is explained by more rigorous selection of patients for coronary angiography and low probability of intact coronary arteries. Conclusions. The existence of correlations between the severity of anatomic lesions of coronary arteries according to the "SYNTAX"-score; the patients' age (r=0,54, p=0,0001); the existence of episodes of ventricular tachyarrhythmia (r=0,52, p=0, 0002); the asynergy index (r=0,40, p=0,008), the total index of metabolic disturbances (r=0,35, p=0,02); the class of heart failure according to the Killip scale (r=0,35, p=0.02); the presence of eccentric hypertrophy of left ventricle (r=0,29, p=0,04) and the index of dyslipidemia (r=0,28, p=0,04).
