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Pre-hospital evaluation of electrocardiographic grade 3 ischemia predicts infarct progression and final infarct size in ST elevation myocardial infarction patients treated with primary percutaneous coronary intervention.

Abstract：

BACKGROUND:In STEMI, grade-3 ischemia (G3) on admission ECG predicts larger infarct size (IS) than grade-2 (G2). We evaluated whether pre-hospital G3 and its temporal behavior are associated with IS and salvage after pPCI. METHODS:In 401 STEMI patients, pre-hospital and pre-PCI ECGs were classified as G3 or G2. IS was assessed by single-photon emission computed tomography (SPECT) at 30days. In 245 patients, pre-PCI SPECT was available to determine myocardium at risk (MaR). RESULTS:G3 criteria were met by 88, and G2 by 313 patients. G3 was independently associated with IS (p=0.006). With ST resolution (STR) group as a reference, G2->G2, G2->G3 and G3->G3 were associated with larger IS (B=4.4, p=0.004; B=5.4, p=0.01; B=10.2, p<0.001, respectively), whereas G3->G2 was not. Salvage was similar between G3 and G2 on pre-hospital ECG if treated early, however lower for G3 when treated later (>2.5h); 48% (35-78) vs 62% (40-87); p=0.04. CONCLUSION:Development or persistence of G3 is associated with larger IS and less salvage, but decreasing grade G3->G2 was not.

journal_name

J Electrocardiol

journal_title

Journal of electrocardiology

authors

Ringborn M,Birnbaum Y,Nielsen SS,Kaltoft AK,Bøtker HE,Pahlm O,Wagner GS,Platonov PG,Terkelsen CJ

doi

10.1016/j.jelectrocard.2014.04.012

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

556-65

issue

4

eissn

0022-0736

issn

1532-8430

pii

S0022-0736(14)00144-7

journal_volume

47

pub_type

杂志文章,随机对照试验

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