Document Detail


Additional ST segment elevation during the first hour of thrombolytic therapy: an electrocardiographic sign predicting a favorable clinical outcome.
MedLine Citation:
PMID:  1452918     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to investigate the significance of further ST elevation that occurs during the 1st h of thrombolytic therapy before the expected resolution. BACKGROUND: Early resolution of ST segment elevation is commonly accepted as a marker of clinical reperfusion during thrombolytic therapy for acute myocardial infarction. Using frequent electrocardiographic recordings, we observed in some patients further ST elevation that occurred during hour 1 of thrombolysis before the expected resolution. METHODS: To investigate the significance of this pattern, we classified 177 consecutive patients with a first acute myocardial infarction into two groups: Group A, 98 patients with ST elevation > or = 1 mm above the initial ST elevation during the 1st h of thrombolytic therapy, and Group B, 79 patients without this finding. RESULTS: Although the presence or absence of additional ST elevation was not associated with a clinical or prognostic difference in patients with a first inferior or posterior acute myocardial infarction, its presence indicated a more favorable clinical outcome and prognosis in patients with anterior infarction. Among the patients with anterior infarction the 65 patients in Group A had a higher ejection fraction (44 +/- 9% vs. 35 +/- 11%, p < 0.01), less heart failure (15% vs. 35%, p = 0.02) and a lower in-hospital mortality rate (0% vs. 8%, p = 0.04) than did the 37 patients from Group B. CONCLUSIONS: Additional ST elevation early during thrombolytic therapy in patients with anterior infarction suggests a favorable clinical outcome and thus may be indicative of successful reperfusion.
Authors:
M Shechter; B Rabinowitz; B Beker; M Motro; G Barbash; E Kaplinsky; H Hod
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  20     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1992-12-31     Completed Date:  1992-12-31     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1460-4     Citation Subset:  AIM; IM    
Affiliation:
Heart Institute, Sheba Medical Center, Tel-Hashomer, Israel.
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MeSH Terms
Descriptor/Qualifier:
Aged
Creatine Kinase / blood
Echocardiography
Electrocardiography / standards*
Female
Gated Blood-Pool Imaging
Hospital Mortality
Hospitals, University
Humans
Infusions, Intravenous
Injections, Intravenous
Isoenzymes
Israel / epidemiology
Male
Middle Aged
Myocardial Infarction / diagnosis,  drug therapy*,  mortality
Myocardial Reperfusion / standards
Predictive Value of Tests
Prognosis
Prospective Studies
Stroke Volume
Thrombolytic Therapy / methods,  standards*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Isoenzymes; EC 2.7.3.2/Creatine Kinase

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