A new formula for evaluating culprit lesion characteristics in STEMI patients based on baseline

Background

Acute myocardial infarction is a leading cause of death worldwide. ST-segment elevated myocardial infarction patients exhibit different plaque morphology depending on many factors. However, the development of pathological states should not be attributed to a single factor alone. Therefore, a new formula is needed to comprehensively predict plaque characteristics to improve patient risk stratification and enable precision management.

Methods

This study include patients first diagnosed ST-segment elevation myocardial infarction who underwent optical coherence tomography before the intervention. NGSA2/P2 = ln ((non-high-density lipoprotein cholesterol / high-density lipoprotein cholesterol)*Glycosylated hemoglobin * admission systolic blood pressure * (Age)²/(platelet count)²) and further divided into three groups, T0 (<4.315), T1(≥4.315, <5.340), T3(≥5.340).

Results

A total of 268 patients were analyzed. Compared to the plaque erosion patients, the plaque rupture patients were older, had lower platelet counts, a higher prevalence of multi-vessel disease, and significantly higher levels of NGSA2/P2. Plaque rupture was positively correlated with age and NGSA2/P2 values, and negatively correlated with platelet counts. Compared to T0 group, the T1 and T2 groups had more cholesterol crystals, macrophages, thin-cap fibroatheromas, smaller normal°, greater lipid-rich° and lipid core index.

Conclusions

The new formula NGSA2/P2 integrates multiple indicators and provides superior predictions of plaque characters compared to the observation single factor. For older patients, it may be particularly important to strengthen the regulation of lipids, blood pressure, blood glucose, and platelet counts.