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Funding Acknowledgements Type of funding sources: None. Background. Total thrombotic occlusion of the LCX may present without ST-segment elevations. Objective. To examine the difference in clinical outcomes between patients with acute MI due to LCX occlusion or stenosis with and without ST-segment elevation. Methods. The present study is a dual center, observational, retrospective cohort study  comprising all patients admitted to between 2009 and 2019 with LCX-related. Results. A total of 897 patients with LCX-related MI were included. Most (56.6%) presented with NSTEMI, which was associated with higher rates of 1-year hospitalization for ACS (15.8% vs 11.1%; P=.05) and PCI (20.9% vs 14.4%; P=.05). STEMI was associated with higher 30-day mortality compared with NSTEMI (3.9% vs 1.7%, P=.05), with no difference in 1-year mortality (6.7% vs 5.6%,  P=.55). Multivariate analysis found left dominant circulation (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.4-4.7) and diabetes mellitus (OR, 2.13; 95% CI, 1.2-3.6) to be independent predictors of 1-year mortality. Conclusion. Patients suffering from NSTEMI and STEMI related to LCX occlusion or stenosis have similar 1-year mortality. Left dominance was associated with higher short- and long-term mortality. These results suggest that a substantial population of patients who present as NSTEMI should be treated promptly and aggressively as STEMI patients.

Prognosis of patients with left circumflex artery acute myocardial infarction in relation to ST-segment on admission electrocardiogram