Incidence of Occluded Culprit Arteries and Impact of Coronary Collaterals on Outcome in Patients With NSTEMI

University of Jena602 enrolled

Overview

It is assumed that patients with non-ST-elevation myocardial infarctions (NSTEMI) showing an infero- or posterolateral occluded culprit artery (OCA) during diagnostic angiography frequently elude standard 12-lead electrocardiogram diagnosis. In addition, coronary collaterals may have beneficial effects in patients with OCA.

We examined consecutive NSTEMI patients within 48 h of symptom onset. All patients underwent early invasive angiography plus optimal medical therapy. We compared baseline characteristics, procedural findings including analysis of TIMI-flow and collaterals using the Rentrop-classification, 30-day and 6-months major adverse cardiovascular events (MACE) in patients with and without totally OCA.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

602

Conditions

NSTEMI

Interventions

percutaneous coronary interventionPROCEDURE

early timing

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age between 18 and 90 years, * onset of angina pectoris at rest \<24 h or crescendo angina in recent weeks with symptoms under minimal exertion or at rest lasting \<24 h, * elevated troponin T ≥0.03 µg/L and * written informed consent. Exclusion Criteria: * persistent angina, * ST-segment elevation myocardial infarction (STEMI), * hemodynamic instability including cardiogenic shock, * oral anticoagulation therapy, * contraindications for glycoprotein IIb/IIIa inhibitors, * other disease with life expectancy \<6 months, * known coagulopathy, * pregnancy, * other suspected causes of troponin elevation as myocarditis, secondary to hypertensive crisis, or after cardiac decompensation, * no ability to consent, and * participation in another study.

Locations (1)

University of Leipzig

Leipzig, Germany

Outcomes

Primary Outcomes

MACE

composite of death, reinfarction and readmission for unstable angina within 6 months after inclusion

Time frame: 6 months

Secondary Outcomes

CK and CK-MB

Venous blood samples were taken at admission (baseline), and every 6 h subsequently for a period of 48 h.

Time frame: 48 hours

Data from ClinicalTrials.gov

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