Key result
In patients with anterior acute myocardial infarction and total occlusion, initial ST-segment elevation ≥10 mm was associated with a significantly lower predischarge left ventricular ejection fraction compared to <10 mm (51% vs 57%, p<0.01).
Why the study?
Does the magnitude of initial ST-segment elevation predict predischarge left ventricular ejection fraction in patients with anterior acute myocardial infarction?
Observational (n=320)
No
Does the magnitude of initial ST-segment elevation predict predischarge left ventricular ejection fraction in patients with anterior acute myocardial infarction?
Initial ST-segment elevation magnitude (∑ST ≥10 mm) is an important predictor of depressed predischarge left ventricular function in patients with anterior AMI and total occlusion, but not in those with spontaneous reperfusion.
BACKGROUND: In the percutaneous coronary intervention (PCI) era, the impact of initial ST-segment elevation magnitude on left ventricular (LV) function in patients with acute myocardial infarction (AMI) remains unclear. METHODS AND RESULTS: In the present study, 239 patients with total occlusion and 81 patients with spontaneous reperfusion within 12 h of their first anterior AMI were evaluated. The sum of ST-segment elevation (SigmaST) was measured in leads I, aV(L) and V(1-6) shortly before angiography. Predischarge LV ejection fraction (LVEF) was obtained at 15+/-5 days. In total occlusion, the predischarge LVEF was significantly lower in patients with SigmaST >/=10 mm than in those with SigmaST <10 mm (51+/-14% vs 57+/-14%, p<0.01). However, in spontaneous reperfusion, there was no significant difference between patients with ST >/=10 mm and those with SigmaST <10 mm (61+/-13 vs 62+/-14 %, p=NS). Predischarge LVEF significantly correlated with SigmaST in total occlusion (r=-0.25, p<0.01), but not in spontaneous reperfusion (r=0.03, p=NS). CONCLUSION: The results suggest that initial SigmaST is an important predictor of LV function in patients with total occlusion, but not in those with spontaneous reperfusion.
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Kurisu et al. (2004) conducted an observational in Anterior Acute Myocardial Infarction (n=320). Initial ST-segment elevation (∑ST) ≥10 mm vs. Initial ST-segment elevation (∑ST) <10 mm was evaluated on Predischarge left ventricular ejection fraction (LVEF) in patients with total occlusion (p=<0.01). In patients with anterior acute myocardial infarction and total occlusion, initial ST-segment elevation ≥10 mm was associated with a significantly lower predischarge left ventricular ejection fraction compared to <10 mm (51% vs 57%, p<0.01).
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