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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

ST-segment resolution after primary percutaneous coronary intervention in patients with acute ST-segment elevation

Gjin Ndrepepa1, Patricia Alger, Sebastian Kufner

  • 1Deutsches Herzzentrum, Technische Universität, Munich, Germany. ndrepepa@dhm.mhn.de

Cardiology Journal
|February 3, 2012
PubMed

Insights

ST-segment resolution after primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) does not predict long-term mortality. This study found no significant difference in five-year mortality rates across different levels of ST-segment resolution.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • The prognostic value of ST-segment resolution following primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction (STEMI) is debated.
  • Conflicting results exist regarding the association between ST-segment resolution and mortality in STEMI patients.

Purpose of the Study:

  • To investigate whether ST-segment resolution, assessed 90-120 minutes after PPCI initiation, predicts long-term mortality in STEMI patients.
  • To clarify the relationship between varying degrees of ST-segment resolution and five-year mortality.

Main Methods:

  • A cohort of 900 STEMI patients treated with PPCI within 24 hours of symptom onset was analyzed.
  • ST-segment resolution was categorized as no (<30%), partial (30%-70%), or complete (>70%) resolution based on ECGs taken 90-120 minutes post-intervention.
  • The primary endpoint was five-year mortality, assessed using Kaplan-Meier estimates and hazard ratios.

Main Results:

  • ST-segment resolution was no resolution in 29%, partial in 40%, and complete in 31% of patients.
  • Overall five-year mortality was 62 deaths.
  • No statistically significant difference in mortality was observed between patients with no, partial, or complete ST-segment resolution (adjusted HR for complete vs. no resolution: 0.91; 95% CI: 0.61-1.33; p=0.607).

Conclusions:

  • ST-segment resolution assessed 90-120 minutes after PPCI in STEMI patients is not a predictor of long-term mortality.
  • Clinical outcomes in STEMI patients treated with PPCI are not significantly influenced by the degree of early ST-segment resolution.
Abstract

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