关键词: 非ST段抬高, 心肌梗死, 危险分层, 冠状血管造影术

Abstract:

Objective To investigate the influential factors of early risk stratification in non-ST-segment elevation acute myocardial infarction(NSTEMI).Methods QT dispersion(QTd),cardiac troponin I(cTNI),C-reactive protein(CRP),presence of ST-segment depression were measured and coronary angiography(CAG) undertaken in 102 patients with NSTEMI.According to the results of CAG(single-vessel,two-vessel and triple-vessel changes in CAG),the 102 patients were divided into three groups(groups 1,2 and 3).Results Although there was no significant difference in the basic characters among the three groups,the percentage of male was higher than that of the female(P<0.001).Patients in group 1 had lower QTd,cTNI,CRP and fewer presence of ST-segment depression than the others.The percentage of diabetes mellitus in the group 2 and group 3 was higher than that in group 1(P<0.05).Multivariable logistic regression analysis suggested that aging、history of diabetes、elevated QTd、cTNI and CRP、presence of ST-segment depression were predictors of early risk stratification(OR:1.401,1.632,2.041,2.322,2.102 and 1.310 respectively).Reinfarction,recurrent angina and congestive heart failure were more frequently seen in patients with 4 factors than those with one factor only(P<0.05);but there were no significant difference in the occurrence of cardiogenic shock and mortality.Conclusion Aging,History of diabetes,elevated QTd,cTNI and CRP,presence of ST-segment depression are independent predictors of early risk stratification in NSTEMI,which are associated with severe ischemia and multivessel coronary artery disease and indicate a poor prognosis.

Key words: Nonk-ST-segment elevation, myocardial infarction, risk stratification, coronary angiography