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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

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Prognostic impact of terminal T wave inversions on presentation in patients with ST-elevation myocardial infarction

Yuichi J Shimada1, Jose Ricardo F Po, Yumiko Kanei

  • 1Department of Medicine, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, New York, NY, USA. yshimada@chpnet.org

Journal of Electrocardiology
|January 15, 2013
PubMed

Insights

Terminal T wave inversions (TTWI) in ST-elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) predict worse in-hospital outcomes, including major adverse cardiac events and longer hospital stays.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Medical Diagnostics

Background:

  • Terminal T wave inversions (TTWI) signify advanced ST-elevation myocardial infarction (STEMI).
  • Urgent percutaneous coronary intervention (PCI) is a primary treatment for STEMI.

Purpose of the Study:

  • To determine if TTWI predict adverse in-hospital outcomes in STEMI patients treated with urgent PCI.
  • To assess the prognostic value of TTWI compared to other clinical indicators.

Main Methods:

  • Retrospective cohort study of 188 STEMI patients undergoing urgent PCI.
  • Primary endpoint: in-hospital major adverse cardiac event (MACE).
  • Secondary endpoints: ST resolution (STR) post-PCI and length of stay (LOS).

Main Results:

  • TTWI independently associated with increased MACE (adjusted OR 2.8, p=0.03).
  • TTWI linked to inadequate STR (adjusted OR 5.5, p=0.01) and longer LOS (4.1 days, p=0.03).
  • TTWI demonstrated superior predictive ability over ischemic time or Q waves.

Conclusions:

  • TTWI on presentation are an independent risk factor for poor inpatient prognosis in STEMI patients.
  • TTWI serve as a valuable early predictor of adverse outcomes post-PCI.
Abstract

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