Non-ST Elevated Myocardial Infarction

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).

Also Known As:

NSTEMI; Non-ST-Elevation Myocardial Infarction; Infarction, Non-ST-Elevation Myocardial; Infarctions, Non-ST-Elevation Myocardial; Myocardial Infarction, Non-ST-Elevation; Myocardial Infarctions, Non-ST-Elevation; Non ST Elevated Myocardial Infarction; Non ST Elevation Myocardial Infarction; Non-ST-Elevation Myocardial Infarctions

Networked: 1935 relevant articles (74 outcomes, 362 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	ST Elevation Myocardial Infarction
2.	Unstable Angina
3.	Non-ST Elevated Myocardial Infarction
4.	Hemorrhage
5.	Myocardial Infarction

Experts

1.	Roe, Matthew T: 41 articles (03/2021 - 01/2002)
2.	Jeong, Myung Ho: 39 articles (02/2022 - 02/2005)
3.	Cannon, Christopher P: 31 articles (01/2017 - 10/2002)
4.	Peterson, Eric D: 30 articles (03/2021 - 05/2005)
5.	Wang, Tracy Y: 24 articles (01/2022 - 04/2009)
6.	Chen, Anita Y: 19 articles (03/2021 - 11/2005)
7.	Morrow, David A: 17 articles (01/2022 - 06/2002)
8.	Danchin, Nicolas: 17 articles (12/2021 - 06/2009)
9.	Wiviott, Stephen D: 17 articles (11/2017 - 02/2004)
10.	Gibson, C Michael: 16 articles (11/2020 - 11/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Non-ST Elevated Myocardial Infarction:

1.	Clopidogrel (Plavix)FDA Link 04/30/2010 - "In combination with previous economic analyses of clopidogrel in NSTEMI patients, this paper demonstrates that clopidogrel appears to offer a cost-effective treatment option for all ACS patients." 06/03/2014 - "Although clinical trials have demonstrated the efficacy of clopidogrel to reduce cardiovascular (CV) morbidity and mortality in medically managed patients with UA or NSTEMI, the effectiveness of clopidogrel in actual clinical practice is less certain. " 09/01/2010 - "Reported practice patterns of clopidogrel administration before PCI for UA/NSTEMI were not consistent with evidence generated from published clinical trials and guidelines. " 09/04/2023 - "A decrease in PDW < 9.9% measured 24 h after clopidogrel treatment in NSTEMI patients has good prognostic value for determining the short-term risks of MACEs, possibly providing a better risk stratification of those patients." 01/01/2022 - "European NSTEMI guidelines-return of clopidogrel?"
2.	omega-Chloroacetophenone (Mace)IBA 03/01/2019 - "In this study, we suggest that the combination of BB with ACEI may be beneficial for reducing the cumulative incidences of MACE, total revascularization rate, and TVR rather than the BB with ARB after PCI with DES in NSTEMI patients." 01/01/2021 - "This increase has been largely driven by an increasing number of NSTEMI patients diagnosed with SCAD, associated with a significant improvement in 30-day MACE." 01/01/2023 - "This study aims to elucidate the correlation between SIRI and major adverse cardiovascular events (MACE) in patients with NSTEMI. " 08/01/2011 - "In patients with UA/NSTEMI, our study showed that MACE and mortality were increased in elderly, female and presence of anaemia. " 11/17/2023 - "For NSTEMI, adjusted rates of MACE were 77.5[95% confidence interval 65.1-92.1] for the most remote area versus 83.4[65.5-106.3] for the least remote area per 1000 person-years. "
3.	Heparin (Liquaemin)FDA LinkGeneric 03/31/2023 - "Patients with a documented DOAC home medication and a diagnosis of NSTEMI were included. Data was collected for heparin anti-Xa levels at baseline, after 6 and 12 hours of hospitalization, in addition to the reason for the delay in the administration of heparin. " 03/31/2023 - "On this background, we evaluate if an elevated heparin anti-Xa assay may lead to the decision to delay heparin in the management of NSTEMI patients and the outcome of in-hospital mortality. " 03/01/2023 - "A heparin drip was initiated for possible non-ST-elevation myocardial infarction. " 07/01/2011 - "Unfractionated heparin (UFH) has been shown to reduce death and MI in patients with USA and NSTEMI. " 03/31/2023 - "Collectively, this study demonstrates that the high sensitivity of heparin anti-Xa assay to DOACs affect assay accuracy and result in elevated heparin anti-Xa level with the use of DOACs resulting in delayed start of heparin therapy in treating NSTEMI patients."
4.	TroponinIBA 01/01/2023 - "This study aims to provide insights into clinical and organizational aspects related to the use of different cardiac troponin tests for the diagnosis of NSTEMI. " 01/01/2023 - "The aim of this study was to assess the effectiveness of the Global Registry of Acute Coronary Events and Quick Sequential Organ Failure Assessment-Troponin (qSOFA-T) scores on in-hospital mortality rate in non-ST-elevation myocardial infarction patients. " 01/01/2022 - "Implications of elevated troponin on time-to-surgery in non-ST elevation myocardial infarction(NIHR Health Informatics Collaborative:TROP-CABG study). " 01/01/2022 - "Implications of elevated troponin on time-to-surgery in non-ST elevation myocardial infarction (NIHR Health Informatics Collaborative: TROP-CABG study)." 10/01/2019 - "The study includes one derivation cohort (N = 985) that will be used to develop rule out/rule in algorithms for NSTEMI and NSTE-ACS (if possible) using novel troponin assays, and to validate established NSTEMI algorithms, with and without clinical scoring systems. "
5.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 01/01/2020 - "Patients with MACCE, death, and NSTEMI show enhanced platelet reactivity despite aspirin medication as compared to patients without ischemic events. " 05/01/2015 - "However, at discharge, Australian NSTEMI/UAP survivors were less likely to receive aspirin (84% vs 89%, P = 0.0079, a second anti-platelet agent (57% vs 63%, P = 0.050) or a beta blocker (67% vs 77%, P = 0.0002). " 09/01/2009 - "Multivariate analyses revealed that laboratory-defined aspirin resistance was an independent predictor of non-ST elevation myocardial infarction (P = 0.022). " 09/01/2009 - "Laboratory-defined aspirin resistance was noted in 29 patients (29.9%), and non-ST elevation myocardial infarction was observed in 46 patients (47.4%). " 04/01/2001 - "Patients with UA/NSTEMI and prior aspirin use had a 60% higher risk of death and cardiac ischemic events compared with nonprior aspirin users. "
6.	TicagrelorIBA 01/01/2017 - "In conclusion, chewing a 180 mg ticagrelor loading dose is feasible and facilitates both faster and improved early inhibition of platelet aggregation in NSTEMI patients, compared with a standard oral-loading dose." 01/01/2022 - "The present study suggests that ticagrelor pretreatment reduces periprocedural myocardial injury in high-risk patients with NSTEMI undergoing PCI with expected time intervals >6 hours." 01/01/2022 - "A total of 1216 patients with NSTEMI were deemed eligible for the study: 481 received a ticagrelor loading dose ≤6 hours (mean time, 4.3 ± 1.2 h) and 735 >6 hours (16.1 ± 8.4 hours) before PCI. " 01/01/2022 - "All consecutive patients pretreated with ticagrelor and undergoing PCI for a high-risk NSTEMI have been included in the present analysis. " 01/01/2022 - "Periprocedural Myocardial Injury in High-Risk Patients With NSTEMI Pretreated With Ticagrelor for Less or More Than 6 Hours Before PCI."
7.	bivalirudin (Angiomax)FDA Link 12/01/2013 - "Patients with NSTEMI were randomly assigned to either receive UFH + abciximab or bivalirudin for PCI. " 12/01/2013 - "In patients undergoing PCI for NSTEMI, the reduction of major bleeding by bivalirudin compared with UFH + abciximab was not affected whether a VCD was used." 01/01/2016 - "During the pre-procedural (medication) phase, the use of bivalirudin monotherapy is associated with the lowest rate of bleeding in patients with Non-ST elevation myocardial infarction (Non-STEMI) undergoing an early invasive strategy. " 05/01/2005 - "Efficacy and safety of anticoagulation with bivalirudin in patients with unstable angina or non-ST elevation myocardial infarction (NSTEMI) are currently under investigation in the ACUITY trial. " 02/01/2009 - "Bivalirudin has been associated with decreased bleeding, with similar rates of ischemia in patients with stable angina, unstable angina, non-ST elevation myocardial infarction and elective percutaneous coronary intervention (PCI). "
8.	trans-crotonin (CTN)IBA 02/01/2023 - "Combining copeptin with hs-cTn (99th percentile of the population as the threshold) at admission improved sensitivity in NSTEMI identification at the expense of specificity. " 01/01/2018 - "Adding copeptin to cTn improved the sensitivity and negative predictive value for the diagnosis of NSTEMI compared to cTn alone. " 02/01/2023 - "In five studies with 6,073 participants (900 NSTEMI), the hs-cTn alone (with 'very low' or limit of detection [LoD] threshold) had higher diagnostic sensitivity than the dual-marker strategy (0.98 vs 0.96). " 02/01/2023 - "Primary studies that evaluated the diagnostic accuracy of hs-cTn with and without copeptin in patients with NSTEMI were eligible. " 11/22/2022 - "Studies that assessed the diagnostic accuracy of serial hs-cTn testing in patients suspected of having NSTEMI in the emergency department (ED) were eligible. "
9.	Glycoproteins (Glycoprotein)IBA 12/19/2019 - "The median levels of both glycoproteins were lower in patients with NSTEMI as compared with controls: fibulin‑1, 96.9 μg/ml (interquartile range [IQR], 20-503 μg/ml) vs 111.5 (IQR, 71-457 μg/ml), P = 0.01, and fibulin‑5, 38 ng/ml (IQR, 15-509 ng/ml vs 57 ng/ml (IQR, 26-631 ng/ml), P <0.001. " 03/03/2004 - "Glycoprotein IIb/IIIa inhibitors and the guidelines for treatment of non-ST-elevation myocardial infarction." 11/01/2003 - "African Americans with UA/NSTEMI received glycoprotein IIb/IIIa receptor inhibitors less often than whites (OR, 0.41; 95% CI = 0.19 to 0.91). " 05/26/2016 - "To determine the benefits and harms associated with the following.1. A routine invasive versus a conservative or 'selective invasive' strategy for the management of UA/NSTEMI in the stent era.2. A routine invasive strategy with and without glycoprotein IIb/IIIa receptor antagonists versus a conservative strategy for the management of UA/NSTEMI in the stent era. " 01/01/2014 - "Glycoprotein IIb/IIIa inhibitors use and outcome after percutaneous coronary intervention for non-ST elevation myocardial infarction."
10.	Glucose (Dextrose)FDA LinkGeneric 07/01/2022 - "Correlation between LVEF levels and on admission plasma glucose level showed statistically significant moderate negative correlation, suggesting that the higher was the level of on admission plasma glucose level; the lower was the LV ejection fraction level in first attack of NSTEMI patients. " 07/01/2022 - "The study showed a strong predictor of adverse in-hospital outcome in the various levels of plasma glucose and NSTEMI. " 07/01/2022 - "The objective of the study was to correlate on admission plasma glucose level in non-diabetic patient with in-hospital outcome of patients after first attack of NSTEMI. " 03/16/2022 - "The ability to rule-out NSTEMI for combinations of baseline hs-cTnT or hs-cTnI with copeptin or glucose was compared with the European Society of Cardiology (ESC) hs-cTnT/I-only rule-out algorithms in two independent (one Norwegian and one international multicentre) diagnostic studies. " 12/13/2022 - "NSTEMI patients showed higher expression of GLUT-1 and an enhanced glucose uptake in T cells as compared to CCS patients (p < 0.0001; p = 0.0101, respectively) and HS (p = 0.0071; p = 0.0122, respectively). "

Therapies and Procedures

1.	Therapeutics 05/17/2021 - "The aim of this trial was to demonstrate that an intervention-guided strategy is superior to optimal medical therapy (OMT) alone for treating NSTEMI in elderly individuals. " 01/01/2014 - "With the prevalence of national quality improvement efforts, the use of evidence-based therapies has improved over time among patients with NSTEMI, yet it is unclear whether these improvements have been associated with significant change in short- and long-term mortality for older patients. " 07/01/2003 - "A number of trials have now assessed the safety and efficacy of early revascularization strategies in the treatment of patients with UA/NSTEMI, whereas others have focused on pharmacologic adjunctive therapy. " 01/01/2022 - "Cox interactive item regression was also used to investigate the correlation between the time of intervention therapy and GRACE risk stratification with clinical outcomes and to evaluate the efficacy of intervention therapy in different risk stratifications of patients with NSTEMI. " 08/01/2017 - "Thus, a panel of Italian cardiology experts assembled under the auspices of the "Campania NSTEMI Study Group" for comprehensive discussion and consensus development to provide practical recommendations, for both clinical and interventional cardiologists, regarding optimal management of antithrombotic therapy in patients with NSTEMI. "
2.	Percutaneous Coronary Intervention 12/01/2016 - "We aimed to evaluate the mortality benefit of ACEIs/ARBs in NSTEMI patients treated successfully with percutaneous coronary intervention (PCI). " 07/25/2023 - "The aim of the study was to evaluate the prognostic significance of baseline renal function regarding in-hospital and 1-year mortality among patients with NSTEMI and treated with percutaneous coronary intervention (PCI). " 01/01/2023 - "This study investigated the role of atherogenic index of plasma (AIP) in predicting contrast induced nephropathy (CIN) in patients who underwent percutaneous coronary intervention due to non-ST elevated myocardial infarction. " 01/01/2022 - "This study aimed to examine clinical prognosis among culprit vessel, immediate multivessel, and staged percutaneous coronary intervention (PCI) in patients with NSTEMI and MVD. " 11/03/2021 - "Material and Methods: The study was a single-center retrospective cohort analysis of 399 consecutive patients with NSTEMI (293 male, mean age: 71 ± 10.1 years) undergoing percutaneous coronary intervention. "
3.	Stents 11/15/2016 - "This study was designed to evaluate whether exposed PS on microparticles (MPs) and blood cells were involved in the hypercoagulable state in NSTEMI patients with stent implantation. " 06/20/2022 - "We sought to assess the long-term outcomes of patients with NSTEMI treated either by single or double stent strategy, having an LM bifurcation culprit lesion. " 06/01/2021 - "The first stent was deployed from the proximal of left anterior descending artery (LAD) to the proximal of diagonal for an 80-year-old man who suffered from non-ST-elevation myocardial infarction to make a Culotte dual stent PCI. " 11/28/2018 - "We may consider the modest stent expansion strategy rather than the aggressive stent expansion strategy in IVUS-guided PCI to the culprit lesion of NSTEMI." 11/28/2018 - "In conclusion, the ratio of stent diameter to vessel diameter was the determinant of slow flow in IVUS-guided PCI to the culprit lesion of NSTEMI. "
4.	Drug-Eluting Stents 01/01/2022 - "This retrospective, observational, single-center study included 943 hemodynamically stable patients with NSTEMI and MVD who had undergone successful drug-eluting stent (DES) implantation from January 2014 to December 2019. " 04/01/2020 - "This study demonstrated that improvement of the parameters of left ventricular systolic function after using of drug eluting stent in NSTEMI diabetic patients was not lower to the non diabetic group under same condition. " 10/29/2021 - "It is recommended that for patients with non-ST-elevation myocardial infarction who are indicated to receive a drug-eluting stent, the clinical effectiveness of the treatment must be considered." 04/01/2020 - "So, suggestion of PCI with drug eluting stent may be extended in NSTEMI diabetic patient." 03/01/2019 - "Long-term clinical outcome between beta-blocker with ACEI or ARB in patients with NSTEMI who underwent PCI with drug-eluting stents."
5.	Length of Stay 09/01/2012 - "In a real-world setting of patients admitted with NSTEMI, the use of IS during the initial hospital stay is an independent predictor of improved 3-year survival, regardless of age. " 02/01/2009 - "In conclusion, the study showed that patients with UA or NSTEMI who experience a major bleed have significantly longer hospital stays, higher readmission rates, increased costs, and increased mortality than those without a major bleed. " 11/10/2020 - "Conclusion: CTA significantly reduces the number of ICA and the average length of hospital stay, and increases the positive rate of ICA in NSTEMI patients whose Grace score is low-or moderate-risk. " 11/15/2019 - "In-hospital stay was also longer in the NSTEMI group (9.0 days vs. 15.4 days, p-value = 0.008). " 03/01/2018 - "Twenty patients with acute NSTEMI were recruited during their hospital stay. "