Predictive Value of ST Resolution Analysis Performed Immediately Versus at Ninety Minutes After Primary Percutaneous Coronary Intervention

• Published in: The American journal of cardiology 2010-02, Vol.105 (4), p.467-474
• Main Authors: Kumar, Saurabh, BSc, MBBS, Sivagangabalan, Gopal, MBBS, Hsieh, Calvin, MBBS, Ryding, Alisdair D.S., MBBS, PhD, Narayan, Arun, RN, Chan, Hera, MBBS, Burgess, David C., MBBS, MPH, PhD, Ong, Andrew T.L., MBBS, PhD, Sadick, Norman, MBBS, PhD, Kovoor, Pramesh, MBBS, PhD
• Format: Article
• Language: English
• Subjects: Aged; Angioplasty; Angioplasty, Balloon, Coronary; Anticoagulants - therapeutic use; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Confidence Intervals; Coronary Thrombosis - drug therapy; Coronary Thrombosis - physiopathology; Diseases of the cardiovascular system; Electrocardiography; Female; Heart attacks; Heart Conduction System - drug effects; Heart Conduction System - physiopathology; Heart failure; Heart Failure - drug therapy; Heart Failure - physiopathology; Humans; Male; Medical sciences; Middle Aged; Mortality; Myocardial Infarction - diagnosis; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Myocardial Infarction - physiopathology; Odds Ratio; Patients; Predictive Value of Tests; Prognosis; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Stents; Survival Analysis; Thrombolytic Therapy - methods; Thrombosis; Time Factors; Vasodilator Agents - therapeutic use
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.10.017

ST segment resolution (STR) predicts epicardial and microvascular reperfusion after primary percutaneous coronary intervention (PPCI) or thrombolysis for ST-elevation myocardial infarction. Immediate restoration of epicardial coronary flow, with improved microvascular perfusion, is much more likely with PPCI. However, the predictive value of immediate STR compared to 90 minutes after PPCI remains unknown. In 622 consecutive patients with ST-elevation myocardial infarction (mean age 59 ± 13 years), 217 had complete STR immediately after PPCI (group A), 188 had complete STR only at 90 minutes (group B), and 217 had incomplete STR at either point (group C). The primary end point was mortality and adverse cardiovascular events ([MACE] death, nonfatal repeat myocardial infarction, and heart failure). Group A had a greater left ventricular ejection fraction (53%, 47%, and 46%, p