title: Patients with non-sT-segment elevation myocardial infarction present with more severe systolic and diastolic dysfunction than patients with unstable angina.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Division of Cardiology, Department of Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand. sincw@mahidol.ac.th
authors: Nithima
authors: N
authors: Chaowalit
authors: Ruedeekorn
authors: R
authors: Auesethasak
authors: Yingsak
authors: Y
authors: Santanakorn
authors: Decho
authors: D
authors: Jakrapanichakul
authors: Maytinee
authors: M
authors: Kittipovanonth
authors: Srisakul
authors: S
authors: Chirakarnjanakorn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000503:physiopathology*; D015415:Biomarkers; D017023:Coronary Angiography; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000503:physiopathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
chemical_list: D015415:Biomarkers