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World J Cardiol. May 26, 2026; 18(5): 117800
Published online May 26, 2026. doi: 10.4330/wjc.v18.i5.117800
Published online May 26, 2026. doi: 10.4330/wjc.v18.i5.117800
Letter to the Editor: Culprit coronary occlusion as a stronger short-term prognostic marker over electrocardiographic pattern in acute myocardial infarction
Sahiljeet Singh, Department of Hospital Medicine, Hartford Hospital, Hartford, CT 06106, United States
Neiberg de Alcantara Lima, Division of Cardiology, Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, CT 06106, United States
Author contributions: Singh S and Lima NDA contributed equally to the conception, drafting, critical revision, and final approval of this manuscript, and both take full responsibility for its content.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Neiberg de Alcantara Lima, MD, FACC, FACP, Division of Cardiology, Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, 85 Jefferson Street, Hartford, CT 06106, United States. neiberglima@me.com
Received: December 16, 2025
Revised: December 29, 2025
Accepted: February 13, 2026
Published online: May 26, 2026
Processing time: 154 Days and 15.6 Hours
Revised: December 29, 2025
Accepted: February 13, 2026
Published online: May 26, 2026
Processing time: 154 Days and 15.6 Hours
Core Tip
Core Tip: This letter discusses the study by Kos et al and emphasizes that in acute myocardial infarction, the presence of a totally occluded culprit artery drives short-term mortality risk more than the electrocardiogram classification (ST-segment elevation vs non-ST segment elevation). We also note troponin as a practical, but imperfect, surrogate for infarct size and urge cautious interpretation. Finally, the association between previous statin use and a lower likelihood of presentation with total occlusion suggests plaque stabilizing effects of statins that merit further investigation.