Key result
An increase in ST-segment elevation 1-24 hours after reperfusion, despite initial ST resolution, was associated with lower left ventricular ejection fraction at 6 months (53% vs 62%, p<0.01).
Why the study?
Does an increase in ST-segment elevation 1-24 hours after reperfusion, despite initial ST resolution, predict larger infarct size and poorer LV function in patients with reperfused anterior AMI?
Cohort (n=164)
Does an increase in ST-segment elevation 1-24 hours after reperfusion, despite initial ST resolution, predict larger infarct size and poorer LV function in patients with reperfused anterior AMI?
In patients with reperfused anterior AMI, an increase in ST-segment elevation 1-24 hours after reperfusion, despite initial ST resolution, indicates a larger infarct size and poorer left ventricular function.
Answers are grounded in this paper and cite their sources.
May flag higher-risk reperfused anterior AMI patients; hypothesis-generating and requires prospective validation before informing care.
BACKGROUND: In patients with acute myocardial infarction (AMI), the relationship of serial changes in ST-segment elevation after reperfusion to left ventricular (LV) function remains unclear. METHODS AND RESULTS: The study group comprised 164 patients with reperfused anterior AMI within 6 h of symptom onset. The sum of ST-segment deviation was calculated on admission (SigmaST-admission), and 1 h (SigmaST-1 h) and 24 h (SigmaST-24 h) after reperfusion. ST resolution was defined as a reduction in SigmaST-1 h of > or =50% as compared with SigmaST-admission. Patients were classified into 3 groups: group A, 82 patients with ST resolution in whom SigmaST-1 h > or = SigmaST-24 h; group B, 37 patients with ST resolution in whom SigmaST-1 h < SigmaST-24 h; group C, 45 patients without ST resolution. Peak creatine kinase were higher in groups B and C than in group A (4,578+/-2,176, 4,236+/-2,638, 2,222+/-1,926 mU/ml, p<0.01). At 6 months follow-up, the LV ejection fraction were lower in groups B and C than in group A (53+/-8, 54+/-12, 62+/-9%, p<0.01). CONCLUSIONS: An increase in ST-segment elevation 1-24 h after reperfusion, despite ST resolution, is associated with a larger infarction and poorer LV function in patients with reperfused anterior AMI.
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Okuda et al. (2008) conducted a cohort in Anterior Acute Myocardial Infarction (n=164). Increase in ST-segment elevation 1-24 hours after reperfusion vs. Maintained ST resolution was evaluated on Left ventricular ejection fraction at 6 months (p=<0.01). An increase in ST-segment elevation 1-24 hours after reperfusion, despite initial ST resolution, was associated with lower left ventricular ejection fraction at 6 months (53% vs 62%, p<0.01).
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