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Non ST Elevated Myocardial Infarction

MedGen UID:
901810
•Concept ID:
C4255010
•
Disease or Syndrome
Synonyms: Infarction, Non-ST-Elevation Myocardial; Infarctions, Non-ST-Elevation Myocardial; Myocardial Infarction, Non-ST-Elevation; Myocardial Infarctions, Non-ST-Elevation; Non ST Elevation Myocardial Infarction; Non-ST Elevated Myocardial Infarction; Non-ST-Elevation Myocardial Infarction; Non-ST-Elevation Myocardial Infarctions; NSTEMI

Definition

A myocardial infarction that does not produce elevations in the ST segments of the ELECTROCARDIOGRAM. ST segment elevation of the ECG is often used in determining the treatment protocol (see also ST Elevation Myocardial Infarction). [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVNon ST Elevated Myocardial Infarction

Professional guidelines

PubMed

Choosing between Enoxaparin and Fondaparinux for the management of patients with acute coronary syndrome: A systematic review and meta-analysis.
Bundhun PK, Shaik M, Yuan J
BMC Cardiovasc Disord 2017 May 8;17(1):116. doi: 10.1186/s12872-017-0552-z. PMID: 28482804Free PMC Article
Delays in the treatment of patients with acute coronary syndrome: Focus on pre-hospital delays and non-ST-elevated myocardial infarction.
Mol KA, Rahel BM, Meeder JG, van Casteren BC, Doevendans PA, Cramer MJ
Int J Cardiol 2016 Oct 15;221:1061-6. Epub 2016 Jul 16 doi: 10.1016/j.ijcard.2016.07.082. PMID: 27448533
Diagnosis and management of acute coronary syndrome: an evidence-based update.
Smith JN, Negrelli JM, Manek MB, Hawes EM, Viera AJ
J Am Board Fam Med 2015 Mar-Apr;28(2):283-93. doi: 10.3122/jabfm.2015.02.140189. PMID: 25748771

Recent clinical studies

Etiology

Defining and managing patients with non-ST-elevation myocardial infarction: Sorting through type 1 vs other types.
Cohen M, Visveswaran G
Clin Cardiol 2020 Mar;43(3):242-250. Epub 2020 Jan 10 doi: 10.1002/clc.23308. PMID: 31923336Free PMC Article
Temporal Trends and Outcomes of Mechanical Complications in Patients With Acute Myocardial Infarction.
Elbadawi A, Elgendy IY, Mahmoud K, Barakat AF, Mentias A, Mohamed AH, Ogunbayo GO, Megaly M, Saad M, Omer MA, Paniagua D, Abbott JD, Jneid H
JACC Cardiovasc Interv 2019 Sep 23;12(18):1825-1836. doi: 10.1016/j.jcin.2019.04.039. PMID: 31537282
Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative.
Basir MB, Kapur NK, Patel K, Salam MA, Schreiber T, Kaki A, Hanson I, Almany S, Timmis S, Dixon S, Kolski B, Todd J, Senter S, Marso S, Lasorda D, Wilkins C, Lalonde T, Attallah A, Larkin T, Dupont A, Marshall J, Patel N, Overly T, Green M, Tehrani B, Truesdell AG, Sharma R, Akhtar Y, McRae T 3rd, O'Neill B, Finley J, Rahman A, Foster M, Askari R, Goldsweig A, Martin S, Bharadwaj A, Khuddus M, Caputo C, Korpas D, Cawich I, McAllister D, Blank N, Alraies MC, Fisher R, Khandelwal A, Alaswad K, Lemor A, Johnson T, Hacala M, O'Neill WW; National Cardiogenic Shock Initiative Investigators
Catheter Cardiovasc Interv 2019 Jun 1;93(7):1173-1183. Epub 2019 Apr 25 doi: 10.1002/ccd.28307. PMID: 31025538
ST-Elevation Myocardial Infarction and Non-ST-Elevation Myocardial Infarction: Medical and Surgical Interventions.
Harrington DH, Stueben F, Lenahan CM
Crit Care Nurs Clin North Am 2019 Mar;31(1):49-64. Epub 2018 Dec 21 doi: 10.1016/j.cnc.2018.10.002. PMID: 30736935
Non-ST-Segment Acute Coronary Syndromes.
Hedayati T, Yadav N, Khanagavi J
Cardiol Clin 2018 Feb;36(1):37-52. doi: 10.1016/j.ccl.2017.08.003. PMID: 29173680

Diagnosis

DISENGAGE Registry.
Pellicano M, Ciccarelli G, Xaplanteris P, Di Gioia G, Milkas A, Colaiori I, Heyse A, Van Durme F, Vanderheyden M, Bartunek J, De Bruyne B, Barbato E
Circ Cardiovasc Interv 2020 Nov;13(11):e008640. Epub 2020 Nov 2 doi: 10.1161/CIRCINTERVENTIONS.119.008640. PMID: 33131299
Defining and managing patients with non-ST-elevation myocardial infarction: Sorting through type 1 vs other types.
Cohen M, Visveswaran G
Clin Cardiol 2020 Mar;43(3):242-250. Epub 2020 Jan 10 doi: 10.1002/clc.23308. PMID: 31923336Free PMC Article
Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative.
Basir MB, Kapur NK, Patel K, Salam MA, Schreiber T, Kaki A, Hanson I, Almany S, Timmis S, Dixon S, Kolski B, Todd J, Senter S, Marso S, Lasorda D, Wilkins C, Lalonde T, Attallah A, Larkin T, Dupont A, Marshall J, Patel N, Overly T, Green M, Tehrani B, Truesdell AG, Sharma R, Akhtar Y, McRae T 3rd, O'Neill B, Finley J, Rahman A, Foster M, Askari R, Goldsweig A, Martin S, Bharadwaj A, Khuddus M, Caputo C, Korpas D, Cawich I, McAllister D, Blank N, Alraies MC, Fisher R, Khandelwal A, Alaswad K, Lemor A, Johnson T, Hacala M, O'Neill WW; National Cardiogenic Shock Initiative Investigators
Catheter Cardiovasc Interv 2019 Jun 1;93(7):1173-1183. Epub 2019 Apr 25 doi: 10.1002/ccd.28307. PMID: 31025538
ST-Elevation Myocardial Infarction and Non-ST-Elevation Myocardial Infarction: Medical and Surgical Interventions.
Harrington DH, Stueben F, Lenahan CM
Crit Care Nurs Clin North Am 2019 Mar;31(1):49-64. Epub 2018 Dec 21 doi: 10.1016/j.cnc.2018.10.002. PMID: 30736935
Non-ST-Segment Acute Coronary Syndromes.
Hedayati T, Yadav N, Khanagavi J
Cardiol Clin 2018 Feb;36(1):37-52. doi: 10.1016/j.ccl.2017.08.003. PMID: 29173680

Therapy

Effect of Routine Invasive vs Conservative Strategy in Older Adults With Frailty and Non-ST-Segment Elevation Acute Myocardial Infarction: A Randomized Clinical Trial.
Sanchis J, Bueno H, Miñana G, Guerrero C, Martí D, Martínez-Sellés M, Domínguez-Pérez L, Díez-Villanueva P, Barrabés JA, Marín F, Villa A, Sanmartín M, Llibre C, Sionís A, Carol A, García-Blas S, Calvo E, Morales Gallardo MJ, Elízaga J, Gómez-Blázquez I, Alfonso F, García Del Blanco B, Núñez J, Formiga F, Ariza-Solé A
JAMA Intern Med 2023 May 1;183(5):407-415. doi: 10.1001/jamainternmed.2023.0047. PMID: 36877502Free PMC Article
Diagnosis and Treatment of Acute Coronary Syndromes: A Review.
Bhatt DL, Lopes RD, Harrington RA
JAMA 2022 Feb 15;327(7):662-675. doi: 10.1001/jama.2022.0358. PMID: 35166796
Contemporary NSTEMI management: the role of the hospitalist.
Pollack CV, Amin A, Wang T, Deitelzweig S, Cohen M, Slattery D, Fanikos J, DiLascia C, Tuder R, Kaatz S
Hosp Pract (1995) 2020 Feb;48(1):1-11. Epub 2020 Feb 20 doi: 10.1080/21548331.2020.1701329. PMID: 31815570
Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative.
Basir MB, Kapur NK, Patel K, Salam MA, Schreiber T, Kaki A, Hanson I, Almany S, Timmis S, Dixon S, Kolski B, Todd J, Senter S, Marso S, Lasorda D, Wilkins C, Lalonde T, Attallah A, Larkin T, Dupont A, Marshall J, Patel N, Overly T, Green M, Tehrani B, Truesdell AG, Sharma R, Akhtar Y, McRae T 3rd, O'Neill B, Finley J, Rahman A, Foster M, Askari R, Goldsweig A, Martin S, Bharadwaj A, Khuddus M, Caputo C, Korpas D, Cawich I, McAllister D, Blank N, Alraies MC, Fisher R, Khandelwal A, Alaswad K, Lemor A, Johnson T, Hacala M, O'Neill WW; National Cardiogenic Shock Initiative Investigators
Catheter Cardiovasc Interv 2019 Jun 1;93(7):1173-1183. Epub 2019 Apr 25 doi: 10.1002/ccd.28307. PMID: 31025538
Revascularization Strategies for Non-ST-Elevation Myocardial Infarction.
George B, Misumida N, Ziada KM
Curr Cardiol Rep 2019 Apr 10;21(5):39. doi: 10.1007/s11886-019-1125-9. PMID: 30969393

Prognosis

Cardiogenic shock complicating non-ST-segment elevation myocardial infarction: An 18-year study.
Vallabhajosyula S, Bhopalwala HM, Sundaragiri PR, Dewaswala N, Cheungpasitporn W, Doshi R, Prasad A, Sandhu GS, Jaffe AS, Bell MR, Holmes DR Jr
Am Heart J 2022 Feb;244:54-65. Epub 2021 Nov 11 doi: 10.1016/j.ahj.2021.11.002. PMID: 34774802
Non-ST segment elevation myocardial infarction in the elderly.
Jiménez-Méndez C, Díez-Villanueva P, Alfonso F
Rev Cardiovasc Med 2021 Sep 24;22(3):779-786. doi: 10.31083/j.rcm2203084. PMID: 34565076
DISENGAGE Registry.
Pellicano M, Ciccarelli G, Xaplanteris P, Di Gioia G, Milkas A, Colaiori I, Heyse A, Van Durme F, Vanderheyden M, Bartunek J, De Bruyne B, Barbato E
Circ Cardiovasc Interv 2020 Nov;13(11):e008640. Epub 2020 Nov 2 doi: 10.1161/CIRCINTERVENTIONS.119.008640. PMID: 33131299
Defining and managing patients with non-ST-elevation myocardial infarction: Sorting through type 1 vs other types.
Cohen M, Visveswaran G
Clin Cardiol 2020 Mar;43(3):242-250. Epub 2020 Jan 10 doi: 10.1002/clc.23308. PMID: 31923336Free PMC Article
Temporal Trends and Outcomes of Mechanical Complications in Patients With Acute Myocardial Infarction.
Elbadawi A, Elgendy IY, Mahmoud K, Barakat AF, Mentias A, Mohamed AH, Ogunbayo GO, Megaly M, Saad M, Omer MA, Paniagua D, Abbott JD, Jneid H
JACC Cardiovasc Interv 2019 Sep 23;12(18):1825-1836. doi: 10.1016/j.jcin.2019.04.039. PMID: 31537282

Clinical prediction guides

Effect of Routine Invasive vs Conservative Strategy in Older Adults With Frailty and Non-ST-Segment Elevation Acute Myocardial Infarction: A Randomized Clinical Trial.
Sanchis J, Bueno H, Miñana G, Guerrero C, Martí D, Martínez-Sellés M, Domínguez-Pérez L, Díez-Villanueva P, Barrabés JA, Marín F, Villa A, Sanmartín M, Llibre C, Sionís A, Carol A, García-Blas S, Calvo E, Morales Gallardo MJ, Elízaga J, Gómez-Blázquez I, Alfonso F, García Del Blanco B, Núñez J, Formiga F, Ariza-Solé A
JAMA Intern Med 2023 May 1;183(5):407-415. doi: 10.1001/jamainternmed.2023.0047. PMID: 36877502Free PMC Article
Non-ST segment elevation myocardial infarction in the elderly.
Jiménez-Méndez C, Díez-Villanueva P, Alfonso F
Rev Cardiovasc Med 2021 Sep 24;22(3):779-786. doi: 10.31083/j.rcm2203084. PMID: 34565076
DISENGAGE Registry.
Pellicano M, Ciccarelli G, Xaplanteris P, Di Gioia G, Milkas A, Colaiori I, Heyse A, Van Durme F, Vanderheyden M, Bartunek J, De Bruyne B, Barbato E
Circ Cardiovasc Interv 2020 Nov;13(11):e008640. Epub 2020 Nov 2 doi: 10.1161/CIRCINTERVENTIONS.119.008640. PMID: 33131299
Clinical outcomes and need for intensive care after non-ST-segment-elevation myocardial infarction.
Guimarães PO, Sampaio MC, Malafaia FL, Lopes RD, Fanaroff AC, de Barros E Silva PGM, Dos Santos TM, Okada MY, Mouallem ARE, Diniz MDS, Custódio JV, Garcia JCT, Furlan V
Eur J Intern Med 2020 Jun;76:58-63. Epub 2020 Feb 20 doi: 10.1016/j.ejim.2020.02.008. PMID: 32089424
Defining and managing patients with non-ST-elevation myocardial infarction: Sorting through type 1 vs other types.
Cohen M, Visveswaran G
Clin Cardiol 2020 Mar;43(3):242-250. Epub 2020 Jan 10 doi: 10.1002/clc.23308. PMID: 31923336Free PMC Article

Recent systematic reviews

Complete Percutaneous Coronary Revascularization in Acute Coronary Syndromes With Multivessel Coronary Disease: A Systematic Review.
Faro DC, Laudani C, Agnello FG, Ammirabile N, Finocchiaro S, Legnazzi M, Mauro MS, Mazzone PM, Occhipinti G, Rochira C, Scalia L, Spagnolo M, Greco A, Capodanno D
JACC Cardiovasc Interv 2023 Oct 9;16(19):2347-2364. doi: 10.1016/j.jcin.2023.07.043. PMID: 37821180
P2Y12 Inhibitors for Non-ST-Segment Elevation Acute Coronary Syndrome: A Systematic Review and Network Meta-Analysis.
Fujisaki T, Kuno T, Briasoulis A, Misumida N, Takagi H, Latib A
Tex Heart Inst J 2023 May 1;50(3) doi: 10.14503/THIJ-22-7916. PMID: 37302149Free PMC Article
Hospital Mortality from Myocardial Infarction in Latin America and the Caribbean: Systematic Review and Meta-Analysis.
Alves L, Ziegelmann PK, Ribeiro V, Polanczyk C
Arq Bras Cardiol 2022 Dec;119(6):970-978. doi: 10.36660/abc.20220194. PMID: 36541993Free PMC Article
Prevalence and outcome of patients with non-ST segment elevation myocardial infarction with occluded "culprit" artery - a systemic review and meta-analysis.
Hung CS, Chen YH, Huang CC, Lin MS, Yeh CF, Li HY, Kao HL
Crit Care 2018 Feb 9;22(1):34. doi: 10.1186/s13054-018-1944-x. PMID: 29422071Free PMC Article
Impact of total occlusion of culprit artery in acute non-ST elevation myocardial infarction: a systematic review and meta-analysis.
Khan AR, Golwala H, Tripathi A, Bin Abdulhak AA, Bavishi C, Riaz H, Mallipedi V, Pandey A, Bhatt DL
Eur Heart J 2017 Nov 1;38(41):3082-3089. doi: 10.1093/eurheartj/ehx418. PMID: 29020244

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