Consilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum9521810.26442/20751753.2020.1.200004Research ArticleThe correlation of the severity of the clinical condition in patientswith acute myocardial infarction without ST-segment elevation and the degree of coronary artery lesion by SYntaX scoreRafaeliIonatan R.rafaeli50@yandex.ruKireevaAlexandra Lu.-KuchkinaNataliia V.-RogatovaAnna N.-TsereteliNino V.-ChernyshevaIrina E.-SemitkoSergei P.-IoselianiDavid G.-Sechenov First Moscow State Medical University15012020221616628122021Copyright © 2020, Consilium Medicum2020Aim. To find the relationship of the clinical status of patients with acute myocardial infarction without ST-segment elevation (NSTEMI) from the baseline condition of the coronary arteries (CA) according on SYNTAX Score (baseline SYNTAX score - BSS). Materials and methods. Were examined 421 patients. All performed coronary angiography and endovascular procedures (EVP) up to 14 days from the beginning of acute myocardial infarction. Assigned 3 groups: 1st - BSS<12 (54.3%), 2nd - BSS 13-22 (23.1%) and 3rd - BSS>22 (22.6%). The clinical condition was assessed by: Killip classification, GRACE scale, left ventricular ejection fraction (LVEF), creatine kinase and creatine kinase-MB data and mortality. Results. Thus, in the group of patients with BSS<12 points pulmonary edema (Killip 3/4) occurred only in one case (0.4%), whereas among patients with BSS>12 points it was detected in 8 4.2%) patients (p<0.05). Pulmonary edema or cardiogenic shock were observed in cases when the infarct related artery (IRA) were: left main spread to the anterior interventricular artery (AIVA), ostium and/or proximal segment of the AIVA. In group 3, high-risk patients according to the GRACE score were observed significantly often (49.5%) vs 2nd (27.8%) and 1st (21.8%) groups respectively (p<0.05). In the third group of cardiospecific enzymes were significantly higher (p<0.05). LVEF<45% was detected in 5.7% of patients of group 1, and in 14.4% and 18.9% in the 2nd and 3rd (p<0.05). Conclusion. Determining factors of the clinical status of patients with NSTEMI are: the degree of lesion of CA according to BSS and hemodynamic significance of the IRA itself. The "line" of differentiation of possible complications in the period before EVP should be considered BSS>12 points.SYNTAXacute myocardial infarction without ST-segment elevationSYNTAXfactors determining the initial clinical condition of patientsострый инфаркт миокарда без подъема сегмента STфакторыопределяющие исходное клиническое состояние больных[Аглуллина Э.И. Острый коронарный синдром: от диагностики к оптимизации лечения. Вестн. современной клинической медицины. 2013; 5: 91-4.][Yeh RW, Sidney S, Chandraetal M. Рориlatten trends in the incidence and outcomes о acute myоcardial infarctiоn. 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