What is the best ST-segment recovery parameter to predict clinical outcome and myocardial infarct size? Amplitude, speed, and completeness of ST-segment recovery after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

Wichert J. Kuijt, Cindy L. Green, Niels J.W. Verouden, Joost D.E. Haeck, Dan Tzivoni, Karel T. Koch, Gregg W. Stone, Alexandra J. Lansky, Samuel Broderick, Jan G.P. Tijssen, Robbert J. de Winter, Matthew T. Roe, Mitchell W. Krucoff

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4 Citations (Scopus)

Abstract

Aims ST-segment recovery (STR) is a strong mechanistic correlate of infarct size (IS) and outcome in ST-segment elevation myocardial infarction (STEMI). Characterizing measures of speed, amplitude, and completeness of STR may extend the use of this noninvasive biomarker. Methods and results Core laboratory continuous 24-h 12-lead Holter ECG monitoring, IS by single-photon emission computed tomography (SPECT), and 30-day mortality of 2 clinical trials of primary percutaneous coronary intervention in STEMI were combined. Multiple ST measures (STR at last contrast injection (LC) measured from peak value; 30, 60, 90, 120, and 240 min, residual deviation; time to steady ST recovery; and the 3-h area under the time trend curve [ST-AUC] from LC) were univariably correlated with IS and predictive of mortality. After multivariable adjustment for ST-parameters and GRACE risk factors, STR at 240 min remained an additive predictor of mortality. Early STR, residual deviation, and ST-AUC remained associated with IS. Conclusions Multiple parameters that quantify the speed, amplitude, and completeness of STR predict mortality and correlate with IS.

Original languageEnglish
Pages (from-to)952
Number of pages1
JournalJournal of electrocardiology
Volume50
Issue number6
DOIs
Publication statusPublished - 1 Nov 2017

Keywords

  • Continuous ST-segment recovery
  • Myocardial infarct size
  • Primary percutaneous coronary intervention
  • Prognosis
  • ST-segment elevation myocardial infarction

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