{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:47:53Z","timestamp":1792702073098,"version":"4.5.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to explore the association between risk stratification and total occlusion (TO) of the culprit artery and multivessel disease (MVD) in patients with non-ST-segment-elevation myocardial infarction (NSTEMI) and to obtain more data on clinical decision-making in addition to risk stratification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively collected data from 835 patients with NSTEMI admitted to our hospital between 1 January 2016 and 1 August 2022. All patients underwent percutaneous coronary intervention (PCI) within 72\u2005h of admission. We excluded patients with a history of cardiac arrest, myocardial infarction, coronary artery bypass grafting, or PCI. Univariate and multivariate regression analyses were performed to determine the predictors of acute TO and MVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 349 (41.8%) patients presented with a TO culprit vessel, whereas 486 (58.2%) had a patent culprit vessel. Thrombolysis in myocardial infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk stratifications were similar between the two groups of patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.712 and 0.991, respectively). The TO infarct vessel was more commonly observed in the left circumflex artery. Patients with TO were more likely to develop MVD (<jats:italic>P<\/jats:italic>\u2009=\u20090.004). Univariate and multivariate linear regression analyses were performed to evaluate the role of variables in the presence of TO and MVD in patients with NSTEMI. Regional wall motion abnormalities (RWMAs) [odds ratio (OR)\u2009=\u20094.022; confidence interval (CI): 2.782\u20135.813; <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001] were significantly linked to TO after adjusting for potentially related variables. Furthermore, age (OR\u2009=\u20091.032; CI: 1.018\u20131.047; <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), hypertension (OR\u2009=\u20091.499; CI: 1.048\u20132.144; <jats:italic>P<\/jats:italic>\u2009=\u20090.027), and diabetes mellitus (OR\u2009=\u20093.007; CI: 1.764\u20135.125; <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001) were independent predictors of MVD in patients with NSTEMI. TIMI and GRACE risk scores were related to MVD prevalence in the multivariate logistic regression model. Patients with a TO culprit vessel had a higher risk of out-of-hospital cardiac death after a 2-year follow-up compared with those without a TO culprit vessel (<jats:italic>P<\/jats:italic>\u2009=\u20090.022).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TIMI and GRACE risk scores were not associated with a TO of the culprit artery; however, they correlated with the prevalence of MVD in patients with NSTEMI. RWMA is an independent predictor of acute TO in patients with NSTEMI. Patients with a TO culprit vessel had worse clinical outcomes than those without a TO culprit vessel.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1382374","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T06:34:22Z","timestamp":1729665262000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical decision-making in patients with non-ST-segment-elevation myocardial infarction: more than risk 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