title: Clinical characteristics and prognostic importance of  mild-to-moderate noninfarct-related coronary artery disease  in patients with first ST-elevation myocardial infarction.
abstract: BACKGROUND
  Among patients hospitalized for an ST-elevation myocardial infarction, the presence of concomitant angiographically severe (≥70%) stenoses in noninfarct-related coronary arteries is associated with poorer in-hospital outcomes. However, there are limited data on patients with angiographically mild-to-moderate (< 70%) noninfarct-related artery (IRA) stenoses.
  
  
  METHODS
  We studied 642 consecutive patients with a first STelevation myocardial infarction presenting to a tertiary medical center. We compared the clinical characteristics and outcomes of patients with isolated IRA disease versus patients with one or more mild-to-moderate non-IRA stenoses versus patients with one or more severe non-IRA stenoses.
  
  
  RESULTS
  Of the 642 patients, 29.8% had isolated IRA disease, 22.6% had one or more mild-to-moderate non-IRA stenoses and 47.7% had one or more severe non-IRA stenoses. The age distribution was 54±12 versus 57±12 versus 58±11 years, with a P value of less than 0.001 and the diabetes prevalence was 27, 28, and 40%, respectively (P=0.003). Among the three groups, the in-hospital mortality was 3.1, 5.5, and 9.8% (P=0.013), the left ventricular ejection fraction was 48, 48, and 45% (P=0.013), and the rate of revascularization was 98, 95, and 88%, respectively (P<0.001).
  
  
  CONCLUSIONS
  Patients with one or more mild-to-moderate non-IRA stenoses had favorable in-hospital outcomes that were comparable with the patients with isolated IRA disease, despite having adverse clinical characteristics that were similar to patients with severe non-IRA stenoses. These results highlight the incremental prognostic importance of angiographical data in patients with ST-elevation myocardial infarction. More research is needed to understand the influence of mild-to-moderate non-IRA stenoses on late outcomes.
authors.affiliation: Cardiac Department, National University Heart Centre, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore 119228, Singapore.
authors.forename: Wern Miin
authors.initials: WM
authors.lastname: Soo
authors.forename: Mark Y
authors.initials: MY
authors.lastname: Chan
authors.forename: Laura
authors.initials: L
authors.lastname: Beck
authors.forename: Shir Lynn
authors.initials: SL
authors.lastname: Lim
authors.forename: Chi Hang
authors.initials: CH
authors.lastname: Lee
authors.forename: Kian Keong
authors.initials: KK
authors.lastname: Poh
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D009204:Myocardial Revascularization; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012846:Singapore; D013997:Time Factors; D016896:Treatment Outcome