Key result
Multilead ST-segment fingerprints during initial PTCA match subsequent reocclusion patterns in 87% of patients.
Why the study?
The reproducibility and stability of multilead ST-segment patterns over time after PTCA and their usefulness in detecting reocclusion were not established.
Are multilead ST-segment 'fingerprints' recorded during PTCA reproducible during subsequent reocclusion episodes?
Observational (n=62)
Are multilead ST-segment 'fingerprints' recorded during PTCA reproducible during subsequent reocclusion episodes?
Multilead ST-segment patterns recorded during PTCA are highly reproducible during subsequent ischemic episodes, suggesting utility as a noninvasive marker for site-specific reocclusion.
May support noninvasive reocclusion localization post-PTCA; hypothesis-generating and leaves open prospective validation before clinical use.
Multilead ST-segment recordings taken during percutaneous transluminal coronary angioplasty (PTCA) could function as an individualized noninvasive template or "fingerprint," useful in evaluating transient ischemic episodes after leaving the catheterization laboratory. To evaluate the reproducibility of such ST-segment patterns over time, these changes were analyzed in patients grouped according to the time between occlusion and reocclusion. For the patients in group 1, the study required comparing their "fingerprints" in repeat balloon inflation during PTCA (reocclusion in less than 1 hour), for those in group 2, comparing ST "fingerprints" during PTCA with ST changes during spontaneous early myocardial infarction (reocclusion in 24 hours) and in group 3, comparing ST "fingerprints" with ST changes during repeat PTCA for restenosis greater than 1 month after the initial PTCA. The ST "fingerprints" among the 20 patients in group 1 were identical in 14 cases (70%) and clearly related in another 4 (20%). Of the 23 patients in group 2, 12 (52%) had the same and 8 (35%) had related patterns. Of 19 patients in group 3, 8 (42% had the same pattern and 8 (42%) had related patterns. Thus, ST fingerprints were the same or clearly related with reocclusion in the same patient from less than 1 hour to greater than 1 month after initial occlusion in 87% of patients overall, in 90% in less than 1 hour, in 87% in less than 24 hours and in 84% greater than 1 month later. Multilead pattern ST-segment "fingerprints" may serve as a noninvasive marker for detecting site-specific reocclusion.
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Krucoff et al. (1988) conducted an observational in Coronary artery disease undergoing PTCA with subsequent reocclusion (n=62). Multilead ST-segment recordings (fingerprints) was evaluated on Identical or clearly related ST-segment patterns during reocclusion compared to initial PTCA. Multilead ST-segment 'fingerprints' recorded during initial PTCA were identical or clearly related to patterns during subsequent reocclusion in 87% of patients overall.
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