Key result
Procedural ST elevation during successful angioplasty is linked to higher risk of subsequent coronary events.
Why the study?
Quantification of total ischemic burden after angioplasty can be improved using microprocessor-driven, multichannel, digital ST-monitoring devices to identify patients at increased risk for coronary events.
May support post-angioplasty risk stratification via multilead monitoring; leaves open whether pattern-guided interventions improve outcomes.
Quantification of total ischemic burden can be improved by use of microprocessor-driven, multichannel, digital, ST-monitoring devices. ST deviation recorded during angioplasty provides a patient-specific template for identification of patients at increased risk for coronary events after angiographically successful dilation. In patients with ST-segment elevation, evidence of these ST "fingerprint" patterns are associated with elevated risk for coronary events in the postangioplasty period. Such risk is not seen in patients with ST-segment depression or with no ST changes. The increased monitoring capability afforded with digitized 3- or 12-lead monitoring creates new criteria for what constitutes accurate determination of total ischemic burden.
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Mitchell W. Krucoff (1988) conducted a review in Silent myocardial ischemia after percutaneous transluminal coronary angioplasty. Multilead ST-monitoring (ST-segment elevation patterns) vs. ST-segment depression or no ST changes was evaluated on Coronary events in the postangioplasty period. In patients after successful angioplasty, ST-segment elevation patterns on multilead monitoring during the procedure are associated with an elevated risk for subsequent coronary events.
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