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

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Predictors and clinical implications of minimal ST-segment elevation in patients with ST-segment elevation myocardial

Se Yong Jang1, Myung Hwan Bae, Jae Hee Kim

  • 1Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.

Cardiology
|June 7, 2014
PubMed

Insights

Patients with minimal ST-segment elevation (STE) myocardial infarction (STEMI) have distinct characteristics, including a higher prevalence of women and better coronary blood flow. However, minimal STE does not predict a better prognosis compared to definite STEMI.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Medical Research

Background:

  • Some patients with suspected ST-elevation myocardial infarction (STEMI) present with ST-segment elevation (STE) not meeting current STEMI diagnostic criteria.
  • This subgroup, termed 'minimal STE,' requires further investigation regarding its unique patient characteristics and clinical outcomes.

Purpose of the Study:

  • To investigate the clinical characteristics of patients with minimal STE.
  • To evaluate the prognosis of patients diagnosed with minimal STE.

Main Methods:

  • A cohort of 546 patients undergoing primary percutaneous coronary intervention (PCI) for STEMI between November 2007 and December 2011 was analyzed.
  • Patients were categorized into minimal STE and definite STEMI groups.

Main Results:

  • The minimal STE group showed a higher proportion of women (30.2% vs. 21.0%), better pre-PCI antegrade flow (30.2% vs. 18.8%), and improved collateralization (27.4% vs. 18.1%) compared to the definite STEMI group.
  • Multivariate analysis identified female gender, good collateral flow, and good pre-PCI antegrade flow as independent predictors for minimal STE.
  • One-year mortality rates were similar between the minimal STE and definite STEMI groups (7.1% vs. 9.3%).

Conclusions:

  • Female gender, good collateral circulation, and adequate pre-PCI antegrade flow are significant predictors of minimal STE in STEMI patients.
  • Despite these distinct characteristics, minimal STE is not associated with an improved prognosis in patients with STEMI.
Abstract

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