Role of ST-Segment Resolution in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention (from the 5-Year Outcomes of the EXAMINATION [Evaluation of the Xience-V Stent in Acute Myocardial Infarction] Trial)

被引：13

作者：

Spitaleri, Giosafat ^{[1
]}

Brugaletta, Salvatore ^{[1
]}

Scalone, Giancarlo ^{[1
]}

Moscarella, Elisabetta ^{[1
]}

Ortega-Paz, Luis ^{[1
]}

Pernigotti, Alberto ^{[1
]}

Gomez-Lara, Josep ^{[2
]}

Cequier, Angel ^{[2
]}

Iniguez, Andres ^{[3
]}

Serra, Antonio ^{[4
]}

Jimenez-Quevedo, Pilar ^{[5
]}

Mainar, Vicente ^{[6
]}

Campo, Gianluca ^{[7
,8
]}

Tespili, Maurizio ^{[9
]}

den Heiler, Peter ^{[10
]}

Bethencourt, Armando ^{[11
]}

Vazquez, Nicolas ^{[12
]}

Valgimigli, Marco ^{[13
]}

Serruys, Patrick W. ^{[14
]}

Sabate, Manel ^{[1
]}

机构：

[1] Univ Hosp Clin, Cardiovasc Clin Inst, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain

[2] Univ Hosp Bellvitge, Dept Cardiol, Barcelona, Spain

[3] Hosp Meixoeiro, Dept Cardiol, Vigo, Spain

[4] Univ Hosp St Pau, Dept Cardiol, Barcelona, Spain

[5] Univ Hosp San Carlos, Dept Cardiol, Madrid, Spain

[6] Hosp Gen Alicante, Dept Cardiol, Alicante, Spain

[7] Azienda Osped Univ Ferrara, Cardiovasc Inst, Ferrara, Italy

[8] Maria Cecilia Hosp, GVM Care & Res, ES Hlth Sci Fdn, Cotignola, Italy

[9] Univ Hosp Bolognini Seriate, Dept Cardiol, Bergamo, Italy

[10] Amphia Ziekenhuis, Dept Cardiol, Breda, Netherlands

[11] Hosp Son Espases, Dept Cardiol, Palma De Mallorca, Spain

[12] Hosp Juan Canalejo, Dept Cardiol, La Coruna, Spain

[13] Univ Hosp Bern, Inselspital, Bern, Switzerland

[14] Imperial Coll London, Int Ctr Circulatory Hlth, London, England

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2018年 / 121卷 / 09期

关键词：

THROMBUS-ASPIRATION; PRIMARY ANGIOPLASTY; REPERFUSION; PREDICTORS; ELECTROCARDIOGRAM; METAANALYSIS; DEFINITIONS; RECOVERY;

D O I：

10.1016/j.amjcard.2018.01.015

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), lack of ST-segment resolution (STR) is associated with poor prognosis at short- and long-term follow-up. The aim of this study was to evaluate the role of STR on very long-term outcomes in patients with STEMI treated with pPCI included in the EXAMINATION (Evaluation of the Xience-V Stent in Acute Myocardial Infarction) trial. Patients were stratified according to the presence of STR <50% and STR < 70% at the 30-minute post-pPCI electrocardiogram. Primary end point was the patient-oriented composite endpoint (POCE) of all-cause death, any myocardial infarction, or any revascularization at 5-year follow-up. Both baseline and post-PCI 30-minute electrocardiograms were available for STR assessment in 1,351 patients. Of these patients, 228 (16.9%) and 500 (37.0%) exhibited STR < 50% and STR < 70%, respectively. At 5-year follow-up, the POCE was observed more frequently in patients with STR < 50% (hazard ratio [HR] 1.556; 95% confidence interval [CI] 1.194 to 2.027; p <0.001) and in patients with STR < 70% (HR 1.460, 95% CI 1.169 to 1.824, p <0.001) compared with patients with STR > 50% and STR >= 70%, respectively. In both cases, this difference was mainly driven by a significant increase in the rate of all-cause death and any revascularization. After multivariable adjustment, STR < 70%, but not STR < 50%, resulted as a 5-year independent predictor of POCE (adjusted HR 1.338, 95% CI 1.008 to 1.778, p = 0.044). In conclusion, in patients with STEM!, the evaluation of 70% STR after pPCI provides independent prognostic information at 5-year follow-up and it can be used to identify patients at high risk of very long-term cardiovascular events. (C) 2018 Elsevier Inc. All rights reserved.

引用

页码：1039 / 1045

页数：7

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