ELECTROCARDIOGRAPHIC FEATURES IN PATIENTS WITH NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION

Abstract

The article presents the results of assessing the characteristics of the dynamics of changes in the ST segment and T wave in patients with myocardial infarction without ST elevation (NSTEMI) depending on the presence of concomitant coronary heart disease and acute myocardial infarction. A total of 200 patients with NSTEMI were examined, including 164 men (82%) and 36 women (18%), 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 coronary artery disease (CAD); group II (n = 106): NSTEMI with CAD, including patients with a recent acute myocardial infarction. 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). 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.