Outcome of ST segment elevated versus non-elevated acute myocardial infarction

ABSTRACT

To determine the outcome of patients with acute ST segment elevated myocardial infarction [STEMI] versus non -ST elevated myocardial infarction [NSTEMI] in our setup. A descriptive study. Cardiology department, Liaquat University Hospital, Hyderabad - Sindh from 1st May 2005 to 31st July 2005. Out of 580 patients hospitalized for acute coronary syndrome, 428 patients of acute myocardial infarction were selected for the study. The patients were selected on the basis of raised biomarkers [CPK, CKMB, SGOT, and LDH/Trop-T] and one of the two i.e. electrocardiography [ECG] changes or history of chest pain. They were grouped into STEMI and NSTEMI. Mean age of the patients was 52 years [range 35-75 years]. Majority of patients [73%] was male and 27% were females. Out of 428 patients selected for study, 288[67.28%] had STEMI while 140 [32.72%] patients had NSTEMI. Recurrent chest pain was present in 85 [29.51%] patients of STEMI; 45 [52.94%] with ECG changes and 40 [47.05%] without ECG changes. In STEMI group, complications were common, more in patients with recurrent chest pain and evidence of ECG changes as compared to those without ECG changes i.e. 16% and 10% respectively. Mortality was also higher [10.5%] in patients of recurrent chest pain and ECG changes compared to those without ECG changes [6.8%]. Among 140 patients of NSTEMI, 48 [34.28%] had recurrent chest pain; 30[62.5%] with ECG changes and remaining 18[37.5%] without ECG changes. In NSTEMI and STEMI patients, recurrent chest pain and ECG changes are bad prognostic markers as compared to recurrent chest pain without ECG changes. These patients are more likely to suffer complications and can benefit from aggressive/invasive strategy than patients with recurrent chest pain without ECG changes. In NSTEMI group, complications and mortality are more frequent in patients with recurrent chest pain and ECG changes compared to those without ECG changes