SO SÁNH ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP KHÔNG ST CHÊNH LÊN CÓ VÀ KHÔNG CÓ RỐI LOẠN CHỨC NĂNG TÂM THU THẤT TRÁI

Abstract

Introduction: Non-ST-elevation myocardial infarction (NSTEMI) is a critical cardiovascular condition with diverse clinical and laboratory characteristics. Left ventricular ejection fraction (LVEF) plays a key prognostic role, especially in patients with left ventricular systolic dysfunction (LVSD). This study aims to describe the clinical and laboratory features of NSTEMI patients and compare those with and without LVSD, contributing to optimizing treatment strategies. Objective: This study aims to describe the clinical and laboratory characteristics of patients with non-ST-elevation myocardial infarction (NSTEMI) and compare those with and without left ventricular systolic dysfunction (LVSD). Subjects: All patients with a first diagnosis of NSTEMI, who were treated at Cho Ray Hospital from February 2024 to April 2024. Study design: A descriptive, cross-sectional, prospective study. Results: During the study period, 117 patients with NSTEMI were included in the analysis. The mean age was 65.5 ± 11.1 years, with a male predominance (62.4%) and nearly half being overweight or obese (49.6%). Most patients had at least one atherosclerotic cardiovascular risk factor (94.9%), with hypertension being the most common (76.9%). The majority were admitted with Killip I (83.8%), while only a small proportion had Killip II (14.5%), Killip III (1.7%), and none had Killip IV. Regarding laboratory findings, most patients had dyslipidemia, characterized by low HDL-C and elevated LDL-C above treatment targets. On admission ECG, 32.5% had normal findings, 67.5% had ST depression or T-wave inversion, and 6.8% had atrial fibrillation. Coronary angiography revealed that 46.2% had triple-vessel disease, and 76.1% had multivessel involvement. The prevalence of left ventricular systolic dysfunction (LVSD, LVEF < 50%) was 46.1%. Patients with LVSD had higher heart rates (82 vs. 77.2 bpm, p = 0.033), a greater proportion with Killip ≥ II (29.6% vs. 4.8%, p < 0.001), higher hs-cTnI levels (15,314.8 vs. 3,277.8 pg/mL, p < 0.001), higher CK-MB (73.5 vs. 41.9 U/L, p = 0.003), and longer hospital stays (5.5 vs. 5 days, p = 0.042). There were no statistically significant differences between the two groups in demographic characteristics, cardiovascular risk factors, coronary artery characteristics, or other biochemical parameters (p > 0.05). Conclusion: NSTEMI patients with LVSD exhibit more severe clinical presentation, greater myocardial injury, and a longer hospital stay compared to those without LVSD.