Document Detail

Does lack of ST-segment resolution still have prognostic value 6 years after an acute myocardial infarction treated with coronary intervention?
MedLine Citation:
PMID:  21658902     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Limited data exist in regard to the correlation between ST-segment resolution (STR) in patients treated with primary percutaneous coronary intervention (pPCI) and very late mortality. The aim of the study was to determine the correlation between STR and 6-year mortality in patients successfully treated with pPCI.
METHODS: We prospectively studied a group of 303 patients who had sustained an acute myocardial infarction with ST-segment elevation and subsequently exhibited TIMI 3 flow after pPCI. The patients were analyzed in 2 groups according to STR.
RESULTS: There were 222 patients (73.3%) with STR and 81 patients (26.7%) without it. The mean "pain-to-balloon" time was 4.3 ± 2.1 hours in the former group vs 4.9 ± 2.8 hours in the latter (P = 0.016). In total, 64 people (21%) died during the 6-year follow-up period: 37 (17%) showed STR and 28 (35%) did not (P < 0.001). In multivariate analysis, STR, ejection fraction, and maximum creatine kinase and creatine kinase-MB levels were all associated with death. Anterior myocardial infarction, "pain-to-balloon" time, and ejection fraction were all further associated with lack of STR.
CONCLUSIONS: Lack of early STR is associated with significantly higher mortality rates after successful pPCI during a 6-year follow-up period. Absence of an early STR appears to identify patients who are less likely to benefit from the early restoration of infarct-affected artery, possibly due to microvascular damage. STR therefore appears to be a powerful prognostic marker for the occurrence of an acute myocardial infarction 6 years later.
Anna Tomaszuk-Kazberuk; Marcin Kozuch; Hanna Bachorzewska-Gajewska; Jolanta Malyszko; Slawomir Dobrzycki; Wlodzimierz J Musial
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-06-11
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  27     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-10-03     Completed Date:  2011-12-13     Revised Date:  2012-02-28    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  573-80     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Department of Cardiology, Medical University in Bialystok, Bialystok, Poland.
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MeSH Terms
Angioplasty, Balloon, Coronary*
Coronary Angiography
Middle Aged
Myocardial Infarction / diagnosis*,  mortality*,  therapy
Time Factors
Treatment Outcome

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