Patients with non-sT-segment elevation myocardial infarction present with more severe systolic and diastolic dysfunction than patients with unstable angina.

Abstract

Patients with non ST-segment elevation acute coronary syndrome (NSTEACS) present with diverse clinical, electrocardiographic, cardiac biomarker, echocardiographic and angiographic characteristics. We sought to determine whether there was any difference in the indices of left ventricular systolic and diastolic function among subgroups of patients with NSTEACS. We studied 121 consecutive patients (mean age 68.6 +/- 11.3 years, 45% male) with NSTEACS who underwent comprehensive echocardiography within 48 hours of admission. Two-dimensional and Doppler echocardiography was performed for the evaluation of left ventricular systolic and diastolic function. Non ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA) were reported in 59% and 41% of patients, respectively. Clinical characteristics (such as age, gender, cardiovascular risk factors, prior myocardial infarction and revascularization, medication) were not significantly different between patients with NSTEMI and UA. Patients with NSTEMI were more likely to have wall motion abnormalities and lower left ventricular ejection fraction (p < 0.05) as compared to those with UA. Diastolic dysfunction was significantly more frequent and more severe in patients with NSTEMI than in those with UA. Among patients with NSTEACS, left ventricular systolic and diastolic dysfunction was more frequent and more severe in patients with NSTEMI that in those with UA. These findings may be used to characterize the sicker group among patients with NSTEACS.