Predictors of ST Depression Resolution in STEMI Patients Undergoing Primary PCI and Its Clinical Significance
Samad Ghaffari1, Kasra Kolahdouzan2, Mehran Rahimi1
1Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
ST depression resolution (STD-R) after primary percutaneous intervention predicts outcomes in anterior ST-elevation myocardial infarction (STEMI). Poor STD-R is linked to heart failure and adverse events, highlighting its prognostic value.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Electrophysiology
Background:
- ST depression resolution (STD-R) is a key prognostic indicator in ST-elevation myocardial infarction (STEMI) treatment.
- Assessing STD-R aids in evaluating the success of reperfusion therapies like angioplasty.
- Predictors and clinical significance of STD-R in anterior STEMI require further elucidation.
Purpose of the Study:
- To determine the clinical significance of ST depression resolution (STD-R) in anterior STEMI patients.
- To identify predictors associated with varying degrees of STD-R post-primary percutaneous intervention (PPCI).
- To evaluate the prognostic value of STD-R for in-hospital outcomes and major adverse cardiac events (MACE).
Main Methods:
- Retrospective analysis of 179 anterior STEMI patients undergoing PPCI.
- Measurement of ST elevation and depression on 12-lead ECGs at admission and 90 minutes post-PPCI.
- Follow-up for 10.8±4.0 months to assess clinical outcomes.
Main Results:
- Lower STD-R (<50%) was associated with female gender, diabetes, non-smoking status, lower hemoglobin, and higher platelet counts.
- STD-R <50% significantly correlated with in-hospital acute heart failure and MACE (p=0.025, p=0.012).
- ST elevation resolution ≥50% was linked to reduced in-hospital mortality (p<0.0001), with significant survival differences between groups (Log rank: 31.18, p<0.0001).
Conclusions:
- ST depression resolution (STD-R) demonstrates significant predictive power for in-hospital acute heart failure and MACE.
- STD-R serves as a valuable prognostic marker, comparable to ST elevation resolution, in anterior STEMI patients post-PPCI.
Purpose:
ST depression resolution (STD-R) in ECG is a prognostic factor indicative of successful fibrinolysis or angioplasty in the treatment of ST elevation myocardial infarction (STEMI) and subsequent mortality. We conducted this study to determine the clinical significance of STD-R and its predictors in patients with anterior STEMI undergoing primary percutaneous intervention (PPCI).
Methods:
Admission documents of all patients with diagnosis of anterior STEMI who were admitted to a specialty heart center and underwent PPCI since July 2018 until July 2019 were examined. The amount of ST elevation and depression in all 12 leads of a standard ECG at admission and 90 minutes after PPCI was measured and resolution was determined. All patients were followed-up for 10.8±4.0 months.
Results:
A total of 179 patients had ST depression besides elevation in the first ECG. Female gender, diabetes, not smoking, lower hemoglobin, and higher platelet counts were significantly more common in the group with less than 50% resolution of ST depression. STD-R <50% was significantly associated with the incidence of in-hospital acute heart failure and major adverse cardiac events (MACE) (p value: 0.025 and 0.012, respectively) and resolution of ST elevation ≥50% was associated with reduced in-hospital mortality (p value <0.0001). According to Kaplan-Meier curve, survival in the two groups of STE-R ≥50% and STE-R <50% was significantly different (Log rank: 31.18, p value<0.0001).
Conclusion:
STD-R can be considered to have high predictive power, like STE-R for predicting incidence of in-hospital acute heart failure and major adverse cardiac events.
More Related Videos
10:03Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:27Coronary Artery Disease V: Interprofessional Care