title: Presence of Severe Stenosis in Most Culprit Lesions of Patients with ST-segment Elevation Myocardial Infarction.
abstract: BACKGROUND
  Previous studies revealed that culprit vessels of ST-segment elevation myocardial infarction (STEMI) were often related to mild or moderate stenosis. However, recent studies suggested that severe stenosis was primarily found in culprit lesions. The objective of this study was to analyze the stenosis severity of culprit lesions in STEMI patients and to clarify the paradoxical results.
  
  
  METHODS
  A total of 489 consecutive STEMI patients who underwent primary percutaneous coronary intervention were retrospectively studied from January 2012 to December 2014. The patients were divided into three groups based on stenosis severity using quantitative coronary analysis: Group A, 314 cases, stenosis ≥70%; Group B, 127 cases, stenosis 50-70%; and Group C, 48 cases, stenosis ≤50%. The clinical, demographic, and angiographic data of all groups were analyzed.
  
  
  RESULTS
  Patients in Group A exhibited a significantly higher prevalence of history of angina pectoris (95.9% vs. 62.5%, P< 0.001), multivessel disease (73.2% vs. 54.2%, P = 0.007), and lower cardiac ejection fraction (53.3 ± 8.6 vs. 56.8 ± 8.4, P= 0.009) than those in Group C. Multivariable analysis revealed that history of angina pectoris (odds ratio [OR]: 13.89, 95% confidence interval [CI]: 6.21-31.11) and multivessel disease (OR: 2.32, 95% CI: 1.25-4.31) were correlated with severe stenosis of the culprit lesion in Group A.
  
  
  CONCLUSIONS
  Most culprit lesions in STEMI patients were severe stenosis. These patients exhibited a higher prevalence of angina history and multivessel diseases.
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Li
authors: L
authors: Sheng
authors: Postgraduate Institute, Harbin Medical University, Harbin, Heilongjiang 150081, China.
authors: Shuang
authors: S
authors: Li
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Jian-Qiang
authors: JQ
authors: Li
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Jing-Yi
authors: JY
authors: Xue
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Yan-Ming
authors: YM
authors: Sun
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Yong-Tai
authors: YT
authors: Gong
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Ling
authors: L
authors: Jing
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Dang-Hui
authors: DH
authors: Sun
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Wei-Min
authors: WM
authors: Li
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Ding-Yu
authors: DY
authors: Wang
authors: Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin Medical University, Harbin, Heilongjiang 150001, China.
authors: Yue
authors: Y
authors: Li
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies