Читать книгу Practical Cardiovascular Medicine - Elias B. Hanna - Страница 42

In-hospital mortality of NSTEMI is lower than STEMI.¹²⁴ However, short-term (30 days) and long-term mortality of NSTEMI approximates STEMI mortality (~3% at 30 days, ~5% at 1 year).^60,62,71,124 Short-term mortality of unstable angina without positive markers or ST changes is much lower (≤ 1.7%).^31,124 The risk of death or MI is 5–10% at 30 days and ~10–15% at 1 year.^59,60,62,64 The risk is much lower beyond the first year (~2% per year).^{65,76,125,126} Half of these events are recurrences at the site of the culprit lesion, while the remaining events are related to non-culprit lesions. Adverse IVUS features (thin cap, heavy atheroma with positive remodeling, small luminal area) predict the progression of a non-culprit lesion to ACS, yet the predictive value is low (~20% progression of this lesion over 3 years).¹²⁶ Angiographic stenosis > 50% in the context of ACS has up to 25% risk of progression in the ensuing 8 months.