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Outcome of all-comers with STEMI based on the grade of ischemia in the presenting ECG

Kimmo Koivula1, Markku Eskola2, Juho Viikilä3

  • 1Internal medicine, Helsinki University Hospital, Finland; Faculty of Medicine and Life Sciences, University of Tampere, Finland.

Journal of Electrocardiology
|July 13, 2018
PubMed

Insights

Patients with ST-elevation myocardial infarction (STEMI) and no grade of ischemia (NG) on ECG have a poor prognosis. Grade 2 ischemia (G2I) indicates a favorable outcome in STEMI patients.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Clinical Research

Background:

  • Grade 3 ischemia (G3I) on electrocardiogram (ECG) predicts poor outcomes in ST-elevation myocardial infarction (STEMI) patients.
  • The prognostic value of G3I in real-world STEMI cohorts remains unclear.

Purpose of the Study:

  • To determine the prognostic significance of G2I, G3I, and STEMI patients without an ischemia grade (NG).
  • To evaluate in-hospital, 30-day, and 1-year mortality and other endpoints in a real-life STEMI population.

Main Methods:

  • Retrospective analysis of a real-life STEMI patient cohort.
  • Assessment of ECG findings including G2I, G3I, and NG.
  • Evaluation of mortality rates and clinical outcomes at various time points.

Main Results:

  • Patients categorized as NG exhibited higher comorbidity burden and treatment delays.
  • Highest short-term and 1-year mortality rates were observed in the NG group, while the G2I group had the lowest.
  • Maximum troponin levels were highest in G3I, followed by NG and G2I.
  • Multivariable analysis identified NG as an independent predictor of 1-year mortality.

Conclusions:

  • No grade of ischemia (NG) is a significant predictor of poor outcomes in STEMI patients.
  • Grade 2 ischemia (G2I) is associated with a relatively favorable prognosis in STEMI.
Abstract

Keywords:
ElectrocardiographyGrade of ischemiaMortalityMyocardial ischemiaPrognosisST-elevation myocardial infarction

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