title: Electrocardiographic comparison of myocardial salvage with primary revascularization versus thrombolysis in inferior myocardial infarction.
abstract: Primary revascularization (PR) and thrombolytic therapy (TT) reduce infarct size and mortality in patients with ST-segment elevation acute myocardial infarction (AMI). Electrocardiogram methods can determine the extent of myocardial salvage with different AMI therapies by comparing infarct size predicted by initial ST-segment changes and infarct size estimated by later quantitative QRS scores. In a community hospital setting, we used quantitative electrocardiogram methods to estimate infarct size and myocardial salvage associated with TT and PR amongst 50 patients presenting with inferior ST-segment elevation AMI. Baseline and electrocardiogram characteristics did not differ between TT (n = 29) and PR (n = 21) patients. There was no difference in median myocardial salvage (%) between TT vs. PR groups, (38.3% vs. 44.9% respectively, P =.66). Among patients with inferior AMI, myocardial salvage was achieved with both TT and PR therapy and did not differ significantly between reperfusion strategies.
authors.affiliation: Duke Clinical Research Institute, Durham NC, USA. mhudson1@hfhs.org
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hudson
authors.forename: Mauricio G
authors.initials: MG
authors.lastname: Cohen
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.forename: Janet
authors.initials: J
authors.lastname: Patterson
authors.forename: Paul T
authors.initials: PT
authors.lastname: Campbell
authors.forename: Kevin
authors.initials: K
authors.lastname: Kruse
authors.forename: Galen S
authors.initials: GS
authors.lastname: Wagner
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D009204:Myocardial Revascularization; D009657:North Carolina; D011237:Predictive Value of Tests; D016879:Salvage Therapy; D000077785:Tenecteplase; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D010959:Tissue Plasminogen Activator; D000077785:Tenecteplase