Usefulness of T Wave Inversion in Leads With ST Elevation on the Presenting Electrocardiogram to Predict Spontaneous Reperfusion in Patients With Anterior ST Elevation Acute Myocardial Infarction

Inversion of the T waves (T−) in electrocardiographic leads with ST-segment elevation after the initiation of reperfusion therapy is considered a sign of reperfusion. However, the significance of T− on presentation before the initiation of reperfusion therapy is unclear. The aim of this study was to...

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Bibliographic Details
Published in:The American journal of cardiology 2014-01, Vol.113 (2), p.270-274
Main Authors: Alsaab, Ayham, MD, Hira, Ravi S., MD, Alam, Mahboob, MD, Elayda, MacArthur, MD, PhD, Wilson, James M., MD, Birnbaum, Y., MD
Format: Article
Language:English
Subjects:
Aged
Cardiology
Cardiovascular
Coronary Angiography
Coronary Circulation - physiology
Coronary vessels
Electrocardiography
Female
Follow-Up Studies
Heart attacks
Humans
Hypertension
Male
Medical imaging
Middle Aged
Myocardial Infarction - diagnosis
Myocardial Infarction - physiopathology
Myocardial Infarction - surgery
Percutaneous Coronary Intervention
Prognosis
Recovery of Function
Retrospective Studies
Veins & arteries
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Summary:Inversion of the T waves (T−) in electrocardiographic leads with ST-segment elevation after the initiation of reperfusion therapy is considered a sign of reperfusion. However, the significance of T− on presentation before the initiation of reperfusion therapy is unclear. The aim of this study was to assess whether T− on presentation predicts patency of the infarct-related artery in patients with acute ST-segment elevation myocardial infarctions (STEMIs) who undergo primary percutaneous interventions. The medical records, electrocardiograms, and angiographic findings of 209 consecutive patients who underwent emergent coronary angiography as part of primary percutaneous coronary intervention protocol activation for STEMI were reviewed. A total of 179 patients (86%) had positive T waves (T+), 16 (8%) had biphasic T waves (T+/−), and 14 (7%) had T−. Patency of the infarct-related artery (Thrombolysis In Myocardial Infarction [TIMI] flow grades 2 and 3) was seen in 64.3% of the patients in the T− group compared with only 31.2% in the T+/− group and 19.0% in the T+ group (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2013.09.018