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ST segment resolution post MI--a predictor of better outcomes.

Shuja-ur-Rehman1, Sidrah Sheikh, Mohsin Nazeer

  • 1Aga Khan University, Karachi.

JPMA. the Journal of the Pakistan Medical Association
|July 29, 2008
PubMed
Summary

Early ST segment resolution on ECG after thrombolysis for myocardial infarction indicates better in-patient outcomes. Patients showing ST resolution had significantly fewer complications like chest pain, heart failure, and arrhythmias.

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Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Myocardial infarction (MI) is a leading cause of mortality globally.
  • Early assessment of MI outcomes is crucial for patient management.
  • Electrocardiogram (ECG) ST segment resolution is a marker of reperfusion after treatment.

Purpose of the Study:

  • To compare in-hospital outcomes of ST-elevation myocardial infarction (STEMI) patients based on early ST segment resolution after thrombolysis.
  • To evaluate the predictive value of ST resolution for major complications in a South Asian population.

Main Methods:

  • Prospective study of 148 STEMI patients treated with streptokinase thrombolysis.
  • Patients were divided into two groups: ST segment resolution (Group A) and no ST segment resolution (Group B) at 60 minutes post-thrombolysis.

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  • In-hospital complications including recurrent chest pain, heart failure, arrhythmias, and death were monitored.

    • Main Results:

    • Group B (no ST resolution) had a significantly higher rate of complications (81%) compared to Group A (35%) (p<0.001).
    • Recurrent chest pain (59% vs 20%), heart failure (62% vs 27%), and arrhythmias (32% vs 10%) were more frequent in Group B.
    • ST segment resolution was strongly associated with a reduced risk of adverse in-hospital events.

    Conclusions:

    • Early ST segment resolution on ECG is a valuable predictor of favorable early clinical outcomes in post-MI patients.
    • Thrombolytic therapy effectiveness can be assessed by ST segment monitoring.
    • This finding is particularly relevant for guiding management in populations undergoing thrombolysis for MI.