Background: the role of presenting ECG in patients with non –ST segment elevation
myocardial infarction as a tool of risk stratification and a predictor of angiographic
outcome,in hospital morbidity and mortality has not been well studied in contemporary
practice. Methods: This is a prospective, observational, non-controlled study included four
hundred patients with NSTEMI admitted at National Heart Institute from August 2014 to
march 2015 and the patients were classified into 4 groups according to ECG findings:
patients with ST depression, patients with T wave inversion,patients with transient ST
elevation and patients with normal ECG findings,100 patient in each group of patients. all
patients were subjected to demographic data analysis, clinical examination, ECG,
echocardiography, coronary angiography. All patients received proper medications and
proper method of revascularization with follow up of morbidity and mortality during
hospital stay. Results: Patients presenting with ST-segment depression were the oldest and
had the greatest prevalence of major cardiac risk factors Angiogram revealed that patients
with ST-segment depression had more left main ,proximal left anterior descending, and 3-
vessel coronary artery disease and underwent coronary artery bypass grafting most often. In
contrast, patients with transient ST-segment elevation had 1-vessel CAD and underwent
percutaneous coronary intervention the most. No ischemic changes group had the seconed
most prevelance of comorbidities , risky angiographic outcomes , in-hospital morbidity and
mortality. Mortality and morbidity was highest in the ST-segment depression group,
then no ischemic changes, T-wave inversion then transient ST-segment followed by the
elevation. Conclusion: Patients with ST-segment depression have a greater burden of comorbidities
and coronary atherosclerosis and have a greater risk of in-hospital morbidity |
