Why the study?
Does ST re-elevation impact ejection fraction or mortality in patients with acute myocardial infarction following reperfusion therapy?
Does ST re-elevation impact ejection fraction or mortality in patients with acute myocardial infarction following reperfusion therapy?
The clinical significance of ST re-elevation after reperfusion therapy in AMI remains unclear due to inconsistent findings across studies.
re-elevation, despite initial ST resolution, occurred in 23% of the patients, and was associated with poorer EF at 6 months. They divided their patients into 3 groups (ST resolution without re-elevation, ST resolution with reelevation, no ST resolution), and showed the serial ECG changes (Figure). In this issue of the Journal, Cuenin et al 8 report that 19% of 662 experienced ST segment re-elevation, but there were no differences in EF or death at 1 year between patients with and without re-elevation. Although the incidence of ST re-elevation was similar to that reported by Okuda et al, the effect on EF was inconsistent. Several differences between the 2 studies may have influenced the results. First, the timing of evaluation for ST re-elevation was different. Most previous studies evaluated ST resolution within several hours after reperfusion therapy, and ST resolution was consistently associated with better clinical outcomes. The mechanism of ST re-elevation is unclear and its occurrence suggests the possibility of re-infarction or pericarditis. In fact, stent
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Kengo Tanabe (2018) studied this question.
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