[Single lead ST-segment resolution in acute ST-elevation myocardial infarction after primary percutaneous coronary intervention: prognostic impact and associated factors]

Da-peng Zhang, Xin-chun Yang, Le-feng Wang, Yong-gui Ge, Hong-shi Wang, Wei-ming Li, Li Xu, Zhu-hua Ni, Yu-ying Luan, Yong-li Xue
Zhonghua Xin Xue Guan Bing za Zhi 2007, 35 (3): 227-32

OBJECTIVE: To evaluate the prognostic value of ST resolution (STR) measured in a single ECG lead obtained early after primary PCI in patients with ST-elevation myocardial infarction (STEMI).

METHODS: In this retrospective study, STR, MACE and factors contributed to STR were analyzed in 964 patients underwent primary PCI post STEMI. The ECGs analysis was made by technicians blinded to the clinical data. MACE was compared between the STR (n = 662) and the non-STR (n = 302) groups. Factors associated with non-STR were analyzed by logistic regression method.

RESULTS: Although TIMI grade III flow was achieved after PCI, non-STR was shown in nearly 1/3 patients and these patients were older, dominant with anterior myocardial infarction, cardiac dysfunction, diabetes and was associated with a higher MACE ratio (25.5% vs. 4.4%, P < 0.001). Cox regression showed that non-STR was one of the independent predictors of in-hospital MACE (RR = 3.33, P < 0.001). Logistic regression showed that anterior myocardial infarction, the pain to balloon time, cardiac dysfunction and white blood cell count on admission were predictive factors of non-STR.

CONCLUSIONS: STR obtained in a single ECG lead is an easy and important prognosticator of MACE post PCI in patients with STEMI. It could therefore be used to identify low- and high-risk STEMI patients post primary PCI.

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