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The association between T wave inversion in leads with ST-elevation and patency of the infarct-related artery
Abdolmohammad Ranjbar1, Bahram Sohrabi1, Seyyed-Reza Sadat-Ebrahimi1
1Cardiovascular Research Center, Tabriz University of Medical Science, Tabriz, Iran.
Insights
T wave inversion on admission electrocardiography (ECG) may indicate spontaneous reperfusion in patients with anterior ST-segment elevation myocardial infarction (STEMI). This finding suggests ECG can identify early recovery without intervention.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Spontaneous reperfusion occurs in over half of ST-segment elevation myocardial infarction (STEMI) patients without intervention.
- Electrocardiography (ECG) is a key diagnostic tool in STEMI management.
Purpose of the Study:
- To assess T wave inversion on ECG as an early indicator of spontaneous reperfusion in STEMI patients.
- To correlate T wave inversion with infarct-related artery patency.
Main Methods:
- Prospective study of 1025 STEMI patients over 3 years.
- ECG analysis on admission and correlation with percutaneous coronary intervention (PCI) outcomes.
- Investigation in both anterior and non-anterior STEMI cases.
Main Results:
- Anterior STEMI patients with T wave inversion showed significantly higher TIMI flow (p=0.001).
- This association between T wave inversion and improved flow was specific to anterior STEMI.
- No significant correlation was found in non-anterior STEMI.
Conclusions:
- On-admission ECG showing T wave inversion in anterior STEMI is a potential marker for spontaneous reperfusion.
- This ECG finding may help identify patients with a patent infarct-related artery early.
Background:
Up to over half of the patients with ST-segment elevation myocardial infarction (STEMI) are reported to undergo spontaneous reperfusion without therapeutic interventions. Our objective was to evaluate the applicability of T wave inversion in electrocardiography (ECG) of patients with STEMI as an indicator of early spontaneous reperfusion.
Methods:
In this prospective study, patients with STEMI admitted to a tertiary referral hospital were studied over a 3-year period. ECG was obtained at the time of admission and patients underwent a PPCI. The association between early T wave inversion and patency of the infarct-related artery was investigated in both anterior and non-anterior STEMI.
Results:
Overall, 1025 patients were included in the study. Anterior STEMI was seen in 592 patients (57.7%) and non-anterior STEMI in 433 patients (42.2%). Among those with anterior STEMI, 62 patients (10.4%) had inverted T and 530 (89.6%) had positive T waves. In patients with anterior STEMI and inverted T waves, a significantly higher TIMI flow was detected (p value = 0.001); however, this relationship was not seen in non-anterior STEMI.
Conclusion:
In on-admission ECG of patients with anterior STEMI, concomitant inverted T wave in leads with ST elevation could be a proper marker of spontaneous reperfusion of infarct related artery.
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