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Prospectively recorded chest pain characteristics, 12-lead ECG, serial hs-cTnT concentrations, time to coronary angiography\/revascularisation, and 5-year mortality were compared in patients with NSTEMI-OMI versus other type I NSTEMI (NSTEMI-NOMI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 801 patients with type I NSTEMI (median age 68\u00a0years, 22.2% female), 251 patients (31.3%) had NSTEMI-OMI. Patients with NSTEMI-OMI presented more often with persistent chest pain (56.1% vs. 37.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), more often had ST-segment depression (34.3% vs. 23.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and exhibited higher and faster rising hs-cTnT concentrations. Time from admission to coronary angiography (median 7.2\u00a0h [IQR 4.7, 21.8] vs. 19.6\u00a0h [IQR 6.2, 27.9],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and coronary revascularisation (median 8.2\u00a0h [IQR 4.9, 24.0] vs. 22.0\u00a0h [IQR 6.3, 46.1],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were both significantly shorter in patients with NSTEMI-OMI versus NSTEMI-NOMI. Five-year mortality was comparable in patients with NSTEMI-OMI versus NSTEMI-NOMI (adjHR 1.13 [95% CI 0.78\u20131.63],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.51).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>One in three patients with type I NSTEMI had NSTEMI-OMI. These patients more often present with very high-risk clinical, ECG, and biomarker features and receive earlier invasive management. Likely related to the latter, 5-year mortality was similar between NSTEMI-OMI and NSTEMI-NOMI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-02966-8","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T07:37:39Z","timestamp":1784705859000},"page":"1870-1883","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Occlusion myocardial infarction in type I NSTEMI: prevalence, characteristics, management, and long-term 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EK reports support from the Swiss Heart Foundation, the University Hospital Basel, the Gottfried and Julia Bangerter-Rhyner Foundation, and speaking\/consulting fees from SpinChip and Boehringer Ingelheim, all outside the submitted work. JB is supported by an Edinburgh Doctoral College Scholarship and research grants from the University of Basel, the University Hospital of Basel, the Division of Internal Medicine, the Swiss Academy of Medical Sciences, the Gottfried and Julia Bangerter-Rhyner Foundation, the Swiss National Science Foundation, and the Swiss Heart Foundation and has received honoraria from Siemens, Roche Diagnostics, Ortho Clinical Diagnostics, Quidel Corporation, and Beckman Coulter and travel support from Medtronic and Vascularmedical, all outside the submitted work. LKoe has received a research grant from the Swiss Heart Foundation, University of Basel, the Swiss Academy of Medical Sciences, the Gottfried and Julia Bangerter-Rhyner Foundation, and the \u201cFreiwillige Akademische Gesellschaft Basel\u201d, as well as speaker honoraria from Roche Diagnostics, Abbott, Siemens, and Dr Risch, paid to the institution and outside the submitted work. KW has received research support from the University of Queensland (PhD scholarship), the Wesley Medical Research Foundation, the University of Basel, and the Swiss National Foundation and received consulting fees from SpinChip, all outside the submitted work. PB received a grant from the Swiss Heart Foundation (FF23062) and receives consulting fees from Scandinavian CRO (SCRO, part\u00a0of\u00a0Aurevia), all outside the submitted work. FM has been supported by Deutsche Forschungsgemeinschaft (SFB TRR219, Project ID 322900939) and Deutsche Herzstiftung. Saarland University has received scientific support from Ablative Solutions, Medtronic, and ReCor Medical. Until May 2024, FM has received speaker honoraria\/consulting fees from Ablative Solutions, Astra-Zeneca, Inari, Medtronic, Merck, Novartis, Philips, and ReCor Medical, all outside the submitted work. CM reports receiving research support from the Swiss National Science Foundation, the Swiss Heart Foundation, Innosuisse, the University Hospital Basel, the University of Basel, Abbott, Beckman Coulter, Brahms, Idorsia, LSI Medience Corporation, Novartis, Ortho Diagnostics, Quidel, Roche, Siemens, Singulex, SpinChip, and Upstream, outside the submitted work, as well as speaker honoraria\/consulting honoraria from Abbott, Amgen, Astra Zeneca, Bayer, Boehringer Ingelheim, BMS, Eli Lilly, Idorsia, Novartis, NovoNordisk, Osler, Roche, SpinChip, and Sanofi, all paid to the institution. All other authors declare no relevant interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}