ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
This article is part of the Research TopicNew Concepts in Revascularization Strategies and Antithrombotic Therapies in Patients With Non-ST Elevated Acute Coronary SyndromesView all 5 articles
Identification of NSTE-ACS Patients with Totally Occluded Infarct-Related Artery: The Role of the SAVE Risk Score in Improved Risk Stratification
Provisionally accepted
- 1The First Affiliated Hospital of Dali University, Dali, China
- 2Yunnan Trans-plateau Cardiovascular Disease of Prevention and Treatment Research Center, Dali, China
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Objective: To investigate the clinical characteristics of NSTE-ACS patients with totally occluded infarct-related artery (IRA-TOCA) and validate the novel SAVE risk score for early identification. Methods: This retrospective study analyzed 185 consecutive NSTEMI patients undergoing coronary angiography, stratified into IRA-TOCA (n=61) and IRA-NTOCA (n=124) groups. Baseline characteristics, angiographic findings, and post-PCI biomarkers were compared. Risk stratification was performed using GRACE and SAVE scores. Results: IRA-TOCA patients exhibited significantly higher post-PCI cTnI levels (8.3 vs 3.34 ng/mL, P=0.001), indicating more severe myocardial injury. Multivariable analysis identified IRA-TOCA (OR 3.64, 95%CI 1.77-7.49) and elevated BNP (OR 1.001, 95%CI 1.000-1.002) as independent predictors of cTnI elevation. The SAVE score demonstrated superior discriminatory ability (sensitivity 73.8%, specificity 54.8%; P<0.001) compared to GRACE score(P=0.384). Left circumflex artery was the most common occlusion site (47.5%). Conclusion: IRA-TOCA represents a high-risk NSTE-ACS subtype with distinct biomarker profiles. The SAVE score enables early identification, potentially guiding timely revascularization.
Keywords: Acute non-ST segment elevation myocardial infarction, totally occluded infarct-related artery, electrocardiogram, risk stratification, SAVE Risk Score
Received: 14 Jan 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Sun, Liu, Ma, Li, Shi, Yang, Ma and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xinhua Wu, 13987286915@139.com
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