Key result
ECG grade III ischemia predicts ~159% higher odds of high thrombus burden during STEMI PCI.
Why the study?
Does electrocardiographic grade III ischemia predict high angiographic thrombus burden in patients with STEMI undergoing pPCI?
Observational (n=307)
Does electrocardiographic grade III ischemia predict high angiographic thrombus burden in patients with STEMI undergoing pPCI?
Odds Ratio: 2.59 (95% CI 1.24–5.39)
p-value: p=0.011
Electrocardiographic grade III ischemia and a history of coronary artery disease are independent predictors of high coronary thrombus burden in STEMI patients undergoing primary PCI.
ECG grade III ischemia may flag higher thrombus burden in STEMI; hypothesis-generating for ECG-guided strategies pending prospective validation.
BACKGROUND: We aimed to investigate the association between electrocardiographic (ECG) grade III ischemia and angiographic thrombus burden in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI). METHODS: The study population consisted of 307 patients with STEMI. Baseline ECGs of the patients were analyzed for grade III ischemia; angiographic thrombus burden was assessed by thrombolysis in myocardial infarction thrombus classification. RESULTS: A total of 108 (35%) patients had low thrombus burden whereas 199 (65%) patients had high thrombus burden. Grade III ischemia was more prevalent in patients with high thrombus burden (25.1% vs 11.1%, P = .004). Only grade III ischemia (odds ratio: 2.59, 95% confidence interval 1.24-5.39, P = .011) and history of coronary artery disease (CAD) were found to be the independent predictors of high thrombus burden. CONCLUSION: Grade III ischemia on ECG and previous history of CAD were independent predictors of coronary thrombus burden in patients with STEMI who underwent pPCI.
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Kurt et al. (2013) conducted an observational in acute ST-segment elevation myocardial infarction (STEMI) (n=307). Grade III ischemia on ECG vs. Absence of Grade III ischemia was evaluated on High angiographic thrombus burden (OR 2.59, 95% CI 1.24-5.39, p=0.011). Grade III ischemia on ECG was an independent predictor of high angiographic thrombus burden in patients with STEMI undergoing primary PCI (OR 2.59; 95% CI 1.24-5.39; P=0.011).
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