Unstable angina / non ST elevation myocardial infarction natural history, complications and prognosis


 * Associate Editor-In-Chief:

List of factors that may effect the development and complications of NSTEMI
(In alphabetical order)


 * Blood lipid levels
 * Catecholamine levels (smoking, cocaine, stress)
 * Degree of coronary vasoconstriction
 * Endothelial function
 * Extent of collaterals
 * Extent of plaque rupture or erosion
 * Inflammatory substrate
 * Location of the culprit coronary lesion
 * Microembolization and microvascular obstruction
 * Stenosis morphology and severity
 * Systemic factors
 * Heart rate and blood pressure


 * Thrombotic factors
 * Blood viscosity
 * Intrinsic clotting activity
 * Leukocyte activation
 * Level of fibrinolytic activity
 * Plaque tissue factor levels
 * Platelet aggregability and reactivity

Prognosis of Unstable Angina Pectoris
The incidence of ischemic complications and the risk of death in unstable angina pectoris is lower than that of patients with either non ST elevation myocardial infarction (NSTEMI) or that or patients with ST segment elevation myocardial infarction (STEMI) but higher than that of patients with chronic stable angina pectoris. The presence of congestive heart failure, new or worsening mitral regurgitation and hypotension (especially during episodes of ischemia) are important determinants of prognosis. The greater the magnitude and duration of EKG changes, the poorer the prognosis.