Key result
No ST resolution at three hours linked to ~290% higher twenty-one day mortality versus complete resolution.
Why the study?
Data from a small prospective study suggested ST segment resolution 3 h after thrombolysis may efficiently predict outcome, but this needed verification in acute myocardial infarction patients.
Does the extent of early ST segment elevation resolution predict mortality and infarct size in patients with acute myocardial infarction?
Population
Patients with acute myocardial infarction from the Intravenous Streptokinase in Acute Myocardial Infarction study database
Comparison
Complete resolution or slight ST elevation vs partial resolution vs no resolution 3 h post-thrombolysis
Design
Cohort study
Follow-up
6-year follow-up
Authors
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Warrants closer surveillance without ST resolution after fibrinolysis; confirms its independent prognostic value in RCT evidence.
Cohort (n=1,516)
Does the extent of early ST segment elevation resolution predict mortality and infarct size in patients with acute myocardial infarction?
Absolute Event Rate: 8.6% vs 2.2%
p-value: p=0.0001
The extent of early ST segment elevation resolution at 3 hours is a strong, independent predictor of infarct size, left ventricular function, and short- and long-term mortality in patients with acute myocardial infarction.
Schröder et al. (1994) conducted a cohort in Acute myocardial infarction (n=1,516). ST segment elevation resolution vs. Complete ST segment resolution was evaluated on 21-day mortality (p=0.0001). No ST segment resolution 3 hours after treatment was a powerful predictor of 21-day mortality (8.6% vs 2.2% for complete resolution; p=0.0001) and long-term survival.
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