ELECTROCARDIOGRAPHY CHARACTERISTICS OF THE PATIENTS WITH NON-ST-ELEVATION MYOCARDIAL INFARCTION
1Republican Medical-Diagnostic Center, Baku Azerbaijan.
Objective:
To assess ECG changes in patients with non-ST-elevation myocardial infarction (NSTEMI).
Materials And Methods:
A total of 200 patients with NSTEMI were examined, including 164 men (82%) and 36 women (18%), aged 33 to 86 years, with a mean age of 62.21±9.38 years. Patients underwent clinical examination and standard 12-lead ECG, GRACE risk assessment and Killip heart failure severity score. Patients were divided into two groups: group I (n=94): NSTEMI without CAD; group II (n=106): NSTEMI with CAD, including recent NSTEMI without ST elevation.
Results:
In patients in group II, ECG changes were more pronounced and diffuse: the frequency of ST depression, T wave inversion, pathological Q wave and conduction disturbances was higher than in group I (p < 0.05). The incidence of ST depression of 77.4% in group II is high for NSTEMI and reflects the more severe risk profile of the cohort (CAD/AMI, GRACE, Killip).
Conclusion:
Pathological Q-waves are associated with more extensive lesions and a worse clinical profile (higher GRACE and Killip II-III), confirming their poor prognostic value. The overall picture (ST depression±Q waves) strengthens the rationale for an early invasive strategy and intensification of therapy in high-risk NSTEMI in accordance with current ESC/ACC/AHA guidelines.
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