ST segment resolution as a tool for assessing the efficacy of reperfusion therapy.
Rapid, simple and inexpensive measures are needed to assess the efficacy of reperfusion therapy both in clinical practice and in clinical trials testing novel reperfusion regimens. In the last decade, several observations have led to a favorable reappraisal of the utility of ST segment monitoring as a simple means of assessing reperfusion in patients receiving fibrinolytic therapy for acute ST elevation myocardial infarction, and ST resolution is being used increasingly in clinical practice and in clinical research. This review focuses on four interrelated roles for ST segment monitoring: the assessment of epicardial reperfusion and the identification of candidates for rescue percutaneous coronary intervention; the evaluation of microvascular and tissue-level reperfusion; the determination of prognosis early after fibrinolytic therapy; and the use of ST segment resolution to compare different reperfusion regimens.
de Lemos
J A
JA
Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas 75093-9034, USA. james.delemos@utsouthwestern.edu
Braunwald
E
E
D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003663:Decision Trees; D004562:Electrocardiography / Q000191:economics / Q000379:methods* / Q000592:standards; D006801:Humans; D008991:Monitoring, Physiologic / Q000191:economics / Q000379:methods* / Q000592:standards; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D015425:Myocardial Reperfusion / Q000379:methods* / Q000592:standards; D009211:Myoglobin / Q000097:blood; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D015912:Thrombolytic Therapy / Q000592:standards*; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D009211:Myoglobin