In-Hospital Outcome of Patients with ST - T Changes in Non ST Segment Elevation Myocardial Infarction

Bangladesh Heart Journal Pub Date : 2022-12-28 DOI:10.3329/bhj.v37i2.63133

Md. Shahadat Hossain, A. Jamil, A. Sarker, S. Haque, M. Ahsan, MD Ali, I. Alam

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Abstract

Background: This cross sectional observational study was carried out with an aim to find out in-hospital outcome in patients with ST-T changes in non-STsegment elevation myocardial infarction (NSTEMI). Methods: This cross sectional observational study was carried out in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from January 2014 to December 2014. A total of 120 patients with NSTEMI were the study population. Patients were divided into two groups on the basis of ST-T changes, 60 patients with ST-T changes were in group I and 60 patients without ST-T changes were in group II. Result: In this study, the mean age was 54.2 ±14.2 years. Male female ratio was 2.75:1 among the study population. There was no statistically significant difference in mean BMI among the two groups. Smoking was the most common risk factor present (47.5%). Smoking was found significantly more in Group I than patients of group II (p=0.02). Serum troponin I was found significantly raised in group I (42.8±5.5 vs 10.5±8.3, p=0.002). The mean left ventricular ejection fraction (LVEF) of patients in group I was significantly lower than group II (52.1±9.1% vs 61.7±6.9%. p=0.001). Adverse in-hospital outcome was significantly more in group I than group II (48.3% vs 26.7%, p=0.01). Recurrent angina pectoris, STEMI, significant arrhythmia, acute LVF and cardiogenic shock were also more in group I than in group II. In-hospital mortality was noted in group I patients with both ST segment depression and T wave inversion (6.7%). Emergency revascularization was done more commonly in patients of group I (6.7%). The mean duration of hospital stay was statistically significant between the groups (6.24±2.58 vs 4.44±1.71 days. p<0.05)). Multivariate logistic regression analysis revealed that ST-T changes are an independent predictor for developing adverse inhospital outcome in patients with non-ST-segment elevation myocardial infarction. Conclusion: The ST-segment depression and T-wave inversion on admission ECG are important predictors of outcome in patients with NSTEMI. The ST-segment depression on admission ECG of patients with NSTEMI is associated with higher adverse in hospital outcome and mortality. Bangladesh Heart Journal 2022; 37(2): 99-106

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非ST段抬高型心肌梗死患者ST - T改变的住院转归

背景:本横断面观察研究旨在了解ST-T改变的非st段抬高型心肌梗死(NSTEMI)患者的住院预后。方法:本横断面观察研究于2014年1月- 2014年12月在孟加拉国达卡国立心血管疾病研究所心内科进行。共有120名NSTEMI患者作为研究人群。根据ST-T改变情况将患者分为两组，有ST-T改变的患者60例为I组，无ST-T改变的患者60例为II组。结果:本组患者平均年龄54.2±14.2岁。研究人群的男女比例为2.75:1。两组患者的平均BMI差异无统计学意义。吸烟是最常见的危险因素(47.5%)。I组吸烟明显多于II组(p=0.02)。I组血清肌钙蛋白I显著升高(42.8±5.5 vs 10.5±8.3,p=0.002)。I组患者平均左室射血分数(LVEF)明显低于II组(52.1±9.1% vs 61.7±6.9%)。p = 0.001)。不良住院结局I组明显多于II组(48.3% vs 26.7%， p=0.01)。复发性心绞痛、STEMI、明显心律失常、急性LVF和心源性休克发生率均高于II组。第一组ST段下陷和T波倒置患者的住院死亡率为6.7%。急诊血运重建术在I组患者中更为常见(6.7%)。两组患者平均住院时间(6.24±2.58天和4.44±1.71天)差异有统计学意义。p < 0.05)。多因素logistic回归分析显示ST-T变化是非st段抬高型心肌梗死患者发生不良住院预后的独立预测因子。结论:入院心电图st段下降和t波反转是预测非stemi患者预后的重要指标。非stemi患者入院心电图st段压低与较高的不良住院预后和死亡率相关。孟加拉国心脏杂志2022;37 (2): 99 - 106

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Bangladesh Heart Journal

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