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Early versus late ST-segment resolution and clinical outcomes after percutaneous coronary intervention for acute myocardial infarction

Netherlands Heart Journal volume 18, pages 416–422 (2010)Cite this article

Abstract

Background. Absence of complete ST-segment resolution (STR) after percutaneous coronary intervention (PCI) for ST-segment-elevation myocardial infarction (STEMI) is a determinant of mortality. Traditionally, STR is determined on the coronary care unit (CCU) 60 to 90 minutes after the initiation of reperfusion therapy. We studied the prognostic value of STR immediately after PCI.

Methods. We analysed 223 consecutive patients with STEMI and successful PCI. Continuous ECG data were collected during PCI and at 30 minutes after arrival on the CCU (mean time 81±17 minutes after reflow of the culprit artery). Patients were divided into three groups: patients with complete STR immediately after PCI (‘early’), patients with complete and persistent STR at 30 minutes on the CCU, but not immediately after PCI (‘late’) and patients without STR. One-year follow-up was obtained for death and rehospitalisation for major adverse cardiac events. Cox proportional hazards regression was used to evaluate the association between STR and outcome.

Results. Early STR occurred in 115 (52%) and late STR in 43 (19%) patients. Patients with early or late STR had a lower incidence of one-year cardiac death than those without STR (1.9 vs. 9.2%; p=0.02). In contrast, rehospitalisation occurred more frequently in patients with early or late STR (20.3 vs. 6.2%; p=0.009). As compared with patients without STR, early and late STR had a similar prognostic value (hazard ratios [95% confidence interval] for cardiac death 0.40 [0.08-2.03] and 0.25 [0.03-2.08]).

Conclusions. We found no (major) change in prognostic value of STR during the 0 to 90 minutes time window after PCI. (Neth Heart J 2010;18:416-22.)

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  1. H. B. van der Zwaan

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  1. H. B. van der Zwaan
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  2. M. G. Stoel
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  3. J. W. Roos-Hesselink
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  4. G. Veen
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  5. E. Boersma
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  6. C. von Birgelen
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Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands

Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the Netherlands

Department of Cardiology, VU University Medical Center, Amsterdam, the Netherlands

Department of Epidemiology and Statistics, Erasmus University, Rotterdam, the Netherlands

Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, and Institute of Biomedical Technology, University of Twente, Enschede, the Netherlands

Department of Cardiology, Thoraxcenter, Erasmus MC, Room Ba 302, PO Box 2040, 3000 CA Rotterdam, the Netherlands

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van der Zwaan, H.B., Stoel, M.G., Roos-Hesselink, J.W. et al. Early versus late ST-segment resolution and clinical outcomes after percutaneous coronary intervention for acute myocardial infarction . NHJL 18, 416–422 (2010). https://doi.org/10.1007/BF03091808

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  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03091808

  • ST-Segment Resolution
  • Percutaneous Coronary Intervention
  • Acute Myocardial Infarction