The prognostic significance of single-lead ST-segment resolution in ST-segment elevation myocardial infarction patients treated with primary PCI - A substudy of the randomized TOTAL trial

被引：0

作者：

Siren, Marko ^{[1
,2
,12
,13
]}

Leivo, Joonas ^{[1
,2
,3
]}

Anttonen, Eero ^{[4
]}

Jolly, Sanjit S. ^{[5
,6
,7
]}

Dzavik, Vladimir ^{[8
]}

Koivumaki, Jyri ^{[3
]}

Tahvanainen, Minna ^{[3
]}

Koivula, Kimmo ^{[9
]}

Wang, Jia ^{[5
,6
,10
]}

Cairns, John A. ^{[11
]}

Niemela, Kari ^{[3
]}

Eskola, Markku ^{[1
,2
,3
]}

Nikus, Kjell C. ^{[1
,2
,3
]}

Hernesniemi, Jussi ^{[1
,2
,3
]}

机构：

[1] Tampere Univ, Fac Med & Hlth Technol, Tampere, Finland

[2] Tampere Univ, Finnish Cardiovasc Res Ctr, Tampere, Finland

[3] Tampere Univ Hosp, Heart Ctr, Dept Cardiol, Tampere, Finland

[4] Paijat sote, Primary Hlth care, Lahti, Finland

[5] Populat Hlth Res Inst, Hamilton, ON, Canada

[6] McMaster Univ, Dept Med, Hamilton, ON, Canada

[7] Hamilton Hlth Sci, Hamilton, ON, Canada

[8] Univ Hlth Network, Peter Munk Cardiac Ctr, Toronto, ON, Canada

[9] South Karel Cent Hosp, Internal Med, Lappeenranta, Finland

[10] Vasc & Stroke Res Inst, David Braley Cardiac, Hamilton, ON, Canada

[11] Univ British Columbia, Vancouver, BC, Canada

[12] Tampere Univ, Fac Med & Hlth Technol, Arvo Ylpon katu 34, Tampere 33520, Finland

[13] Tampere Univ, Finnish Cardiovasc Res Ctr, Arvo Ylpon katu 34, Tampere 33520, Finland

来源：

AMERICAN HEART JOURNAL | 2024年 / 269卷

基金：

加拿大健康研究院;

关键词：

PERCUTANEOUS CORONARY INTERVENTION; MICROVASCULAR OBSTRUCTION; CLINICAL-OUTCOMES; NO-REFLOW; REPERFUSION; RECOVERY; THERAPY; IMPACT; SIZE;

D O I：

10.1016/j.ahj.2023.12.009

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND ST -segment elevation myocardial infarction (STEMI) is associated with high morbidity and mortality worldwide. Simple electrocardiogram (ECG) tools, including ST -segment resolution (STR) have been developed to identify high-risk STEMI patients after primary percutaneous coronary intervention (PCI). SUBJECTS AND METHODS We evaluated the prognostic impact of STR in the ECG lead with maximal baseline STsegment elevation (STE) 30-60 minutes after primary PCI in 7,654 STEMI patients included in the TOTAL trial. Incomplete or no STR was defined as < 70% STR and complete STR as >= 70% STR. The primary outcome was the composite of cardiovascular death, recurrent myocardial infarction (MI), cardiogenic shock, or new or worsening New York Heart Association (NYHA) class IV heart failure at 1-year follow-up. RESULTS Of 7,654 patients, 42.9% had incomplete or no STR and 57.1% had complete STR. The primary outcome occurred in 341 patients (10.4%) in the incomplete or no STR group and in 234 patients (5.4%) in the complete STR group. In Cox regression analysis, adjusted hazard ratio for STR < 70% to predict the primary outcome was 1.56 (95% confidence interval 1.32-1.89; P < .001) (model adjusted for all baseline comorbidities, clinical status during hospitalization, angiographic Findings, and procedural techniques). CONCLUSION In a large international study of STEMI patients, STR < 70% 30-60 minutes post primary PCI in the ECG lead with the greatest STE at admission was associated with an increased rate of the composite of cardiovascular death, recurrent MI, cardiogenic shock, or new or worsening NYHA class IV heart failure at 1-year follow-up. Clinicians should pay attention to this simple ECG Finding.

引用

页码：149 / 157

页数：9

共 23 条

[21] High dose adenosine for suboptimal myocardial reperfusion after primary PCI: A randomized placebo-controlled pilot study [J].