Clinical Outcomes of ST-segment Resolution following Primary Percutaneous Coronary Intervention: A Retrospective, Real-world Analysis from Qatar

Background: Resolution of ST elevation (STE) is the hallmark of successful thrombolysis for ST-elevation myocardial infarction (STEMI). However, the effect of persistent STE on in-hospital outcomes following primary percutaneous coronary intervention (PPCI) is not well established. Methods: In this single-center retrospective cohort analysis, all patients admitted between January 1, 2016, and September 30, 2018, with a diagnosis of STEMI who underwent PPCI were included. Complete resolution was defined as a >70% decrease in the STE sum on the first electrocardiogram following PPCI. Partial resolution denoted a 30%-70% decrease, and persistent STE denoted a <30% decrease or any increase in the STE sum. The study population was divided into two groups: (1) resolved STE incorporating complete and partial resolution and (2) persistent STE incorporating persistent and increased STE. Using multivariate logistic regression, we compared the rates of in-hospital mortality, cardiogenic shock, intensive care unit admission, clinical heart failure, and readmission for a cardiac reason and heart failure between the study groups. Conclusion: Persistent STE following PPCI is a quick clinical indicator of in-hospital adverse outcomes and readmission. Future studies may explore interventions, such as early intensive medical therapy, that can improve outcomes in this population.