Analysis Of Clinical Characteristics And Coronary Angiographic Findings In The Patients With Acute Coronary Syndrome

Objective: To investigate the characteristics of the clinic and angiograms of coronary artery in subgroups of early ACC/AHA risk stratification in unstable angina/ non-ST-segment elevation myocardial infarction (UA/NSTEMI) patients and ST-segment elevation myocardial infarction (STEMI) patients by analyzing the clinical data and coronary angiographic findings in the patients with acute coronary syndrome (ACS).Methods: Select the hospitalized patients with ACS in the second hospital of ShanDong university from January, 2003 to December, 2004. The number of total patients is 138. Male:109 cases, female :29 cases . All patients were performed on coronary angiography(CAG) with the transfemoral approach using the Judkins technique. General data (sex, age), clinical data(past history, symptom, sign), myocardial injury markers(creatine phosphokinase,CK; creatine phosphokinase-MB isoenzyme, CK-MB;troponin T, TNT), electrocardiogram(ECG) changes and coronary angiographic findings (severity of stenosis, position and morphology of lesions) were recorded retrospectively.The patients with UA/NSTEMI underwent early risk stratification according to ACC/AHA(2002) criteria.To analyze the characteristics of the clinic and angiograms of coronary artery in patients with ACS , and to comparethe lesions of culprit artery , including the degree of stenosis, morphology and type of lesion, among subgroups of early ACC/AHA risk stratification in UA/NSTEMI patients.Results:l.The rate of moderate stenosis and type B lesion was significantly higher in the low risk patients (P<0. 05) . The rate of double vessel disease , severe stenosis and type B lesion was significantly higher in the intermediate risk patients(P<0.05). The rate of triple vessel disease, severe stenosis and type C lesion was significantly higher in the high risk patients(P<0.05). The rate of single vessel disease , severe stenosis and type B lesion was significantly higher in the STEMI patients(P<0. 05); The rate of left anterior descending (LAD) coronary artery disease was significantly higher in the whole ACS patients(P<0.05).2. The rate of triple vessel disease, left main stem(LM) disease, severe stenosis, complete occlusion, type C lesion in the high risk patients with UA/NSTEMI was significantly higher than that in the low risk patients with UA/NSTEMI, respectively (37.1% VS9. 1%, 5.7% VS 0%, 50.7% VS 25.0%, 12.7% VS 0%, 54.9% VS 12. 5%; P<0. 01). The high risk patients revealed a significantly lower rate of single vessel disease, LAD disease, type A lesion than that in the low risk patients, respectively (17.1% VS 45. 5%, 45.1% VS 56. 3%, 9.9% VS31.3%; P<0. 01) .Conclusions:1. Study evidence demonstrates that CAG is the best examination approach in patients with ACS, by which wo can get objective message of severity and morphology of coronary lesions. So CAG may play an important role in early risk stratification, treatment and prognosis evaluation.2. The coronary lesions in the high risk patients with UA/NSTEMI are serious, widespread and unstable, which indicates that early invasive strategy was better than early conservative strategy.