| Objective To study the severity of culprit lesion stenosis and its predicting factors in acute ST-segment elevation myocardial infarction (STEMI).Methods All the angiographic and clinical data of patients admitted into Fuwai Hospital for STEMI and received PCI with thrombus aspiration for STEMI between 2014/05 and 2014/10 were retrospectively analyzed. Patients were divided into two groups according to the severity of residual stenosis after aspiration by quantitative coronary angiography:non-obstructive stenosis group (NS) with diameter stenosis<50% and obstructive stenosis group (OS) with diameter stenosis≥50%.The angiographic and clinical characteristics were compared between the 2 groups and the possible predicting factors of non-obstructive stenosis were further studied.Results A total of 123 patients were included into the study. Among them 48 patients (39.0%) had non-obstructive lesions and 75 patients(61.0%) had obstructive lesions. Compared to the obstructive stenosis group, patients with non-obstructive showed less degree of stenosis [37.7±8.5% vs 65.2±10.1%, P=0.000], shorter lesion length [24.3±12.3 mm vs 29.2±13.8 mm, P=0.048] and less proportion of patients needed stent implantation [68.8%(33/48) vs 92.0%(69/75), P=0.001]. More patients in the non-obstructive stenosis group had prior history of PCI compared with the obstructive stenosis group [27.1%(13/48) vs 6.7%(5/75),P=0.002]. Logistic regression analysis showed past PCI history was the only predictive factor for non-obstructive stenosis to be culprit lesion. (OR4.881,95%CI:1.553-15.339;P=0.007). No correlation was found between the culprit lesion with sex, age, Body Mass Index (BMI), comorbidities of hypertension, diabetes, dyslipidemia and peripheral artery disease (all P >0.05).Conclusion About 40% of STEMI was caued by non-obstructive coronary artery stenosis. Prior history of PCI was a predictive factor for non-obstructive stenosis to be... |
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