Document Detail


Differential classification of acute myocardial infarction into ST- and non-ST segment elevation is not valid or rational.
MedLine Citation:
PMID:  20645960     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: The distinction between ST elevation and nonST elevation infarcts is widely accepted and is employed as a guide to management. AIM: This is review of the world literature to assess the basis for this distinction, since the two studies on which it is based are seriously flawed in method and conclusions. METHOD: Pathologic and clinical studies were reviewed from the world literature. FINDING: The pathology of the two subsets is identical as are the morbidity, mortality and clinical course. Non-ST elevation infarcts are likely to be subsequent, to occur in older patients and to involve the circumflex artery: this subset therefore includes a high-risk group. ST deviation in any part of the electric field of the heart will predictably be accompanied by reciprocal deviation if the entire field of the heart is mapped. Further, ST deviation of infarction is often transient, resolving in minutes so that infarcts will be predictably misclassified. ST deviation per se is therefore not a rational basis for classification of infarcts. In fact, invasive therapy is indicated in both subsets with identical results. CONCLUSION: The distinction between ST elevation and non-ST elevation infarcts is baseless. The high risk subgroup included in the non-ST elevation infarct set should not be denied the benefit of early invasive therapy.
Authors:
Brendan Phibbs; William Nelson
Publication Detail:
Type:  Editorial    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  15     ISSN:  1542-474X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  191-9     Citation Subset:  IM    
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