Electrocardiogram dynamics for risk stratification in ST-segment elevation myocardial infarction--immediate and serially updated information on outcome.
Early and serially updated predictions of final infarct-size and clinical outcome--before, during and after reperfusion treatment of ST-elevation myocardial infarction might allow a more individualized treatment: High-risk patients with a predicted major loss of viable myocardium can be identified immediately or during therapy, at a stage when treatment may still be modified; and low-risk patients with predictions of small infarcts and good outcome already after standard primary reperfusion therapy can be identified and thereby avoid a possibly harmful intensified treatment. The necessary information for such predictions seem to be available from the standard 12-lead ECG and from ST-segment monitoring. Today this information, however, is not readily available in clinical practice. Automated algorithms need to be engineered for a broader use and for possibilities of a refined triage and thus for a more individualized strategy of reperfusion therapy.
Johanson
Per
P
Department of Medicine/Cardiology, Coronary Intensive Care Unit, Sahlgrenska University Hospital, Ostra, 416 85 Göteborg, Sweden. pj@hjl.gu.se
D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000601:surgery*; D015425:Myocardial Reperfusion; D017063:Outcome Assessment, Health Care / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome