ECG Characteristics Of Patients With Acute Non ST Segment Elevation Myocardial Infarction With Occluded Culprit Vessel

Objective:To summarize the clinical,coronary angiography and ECG characteristics of patients with acute non-ST segment elevation myocardial infarction whose criminal vessels are occluded vessels,and select characteristic ECG characteristics to identify occluded vessels as criminal vessels earlier,so as to make early diagnosis and reperfusion treatment.Methods:From January 2019 to December 2020,569 patients were diagnosed acute nonST segment elevation myocardial infarction in the first Hospital of Jilin University and emergency coronary angiography were collected.There were 239 patients with single vessel occlusion and 330 patients without vessel occlusion.The clinical data such as gender,age,past history,smoking history,myocardial enzyme,ECG,cardiac ultrasound and coronary angiography were recorded.The onset characteristics of the two groups and the clinical data of different occluded vessels in the occlusion group were analyzed.Results:a total of 569 NSTEMI patients undergoing emergency coronary angiography were included in this study,including 239 patients with single occluded vessel,including 116 patients with circumflex artery,67 patients with right coronary artery,56 patients with anterior descending artery and 330 patients without occluded vessel.In occlusion group,myoglobin rising ratio（P < 0.001）,creatine kinase isoenzyme rising ratio（P = 0.002）,fasting blood glucose（P < 0.05）,aspartate aminotransferase（P < 0.05）,alanine aminotransferase（P < 0.05）and higher troponin peak（P < 0.05）.Joint standard 2 when the probability p > 0.406 is diagnosed as occlusion,the sensitivity of diagnosis is 64.4%,the specificity is 55.8%,the positive predictive value is 51.3%,the negative predictive value is 68.4%,and the correct index is 0.202.Killip grade,MB rising ratio,CK-MB rising ratio,hemoglobin,aminotransferase and higher troponin peak were statistically significant in the occlusion group,and aspartate aminotransferase was relatively high in the circumflex branch group.QRS wavelength,the number of leads with ST segment depression,q / Q wave in the lower wall lead,the proportion of T wave inversion > 1mm,and T wave instability in the chest lead were statistically significant.The q / Q wave in the lower wall lead in the right coronary artery group was relatively high.Conclusion:compared with the non-occlusion group,the values of MB rising ratio,CK-MB rising ratio,fasting blood glucose,aspartate aminotransferase,alanine aminotransferase and the peak of troponin in NSTEMI occlusion group were higher;The patients in occlusion group were mostly multi-vessel lesions,but less collateral circulation;ECG showed that the longer the QRS wavelength,the more the number of leads with ST segment depression,the higher the proportion of ST segment depression ≥ 0.5 mm and the lower the proportion of T wave depression.Among NSTEMI patients in occlusion group,aspartate aminotransferase in circumflex branch group was relatively high,and q / Q wave in inferior wall lead in right coronary artery group was relatively high.