Postprocedural single-lead ST-segment deviation and long-term mortality in patients with ST-segment elevation myocardial infarction treated by primary angioplasty.
OBJECTIVE
To evaluate the prognostic role of postprocedural single-lead residual ST-segment deviation for electrocardiographic evaluation of myocardial perfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary angioplasty.


METHODS
Prospective observational clinical cohort study.


METHODS
Tertiary referral centre.


METHODS
1660 patients treated with primary angioplasty for STEMI.


METHODS
Mortality at 1-year follow-up.


RESULTS
Single-lead ST-segment deviation significantly correlated with infarct size, predischarge ejection fraction, distal embolisation and myocardial blush grade 3. At 1-year follow-up, 63 patients had died. The method correlated well with 1-year mortality. At multivariate analysis, after correction for baseline demographic, clinical and angiographic variables, postprocedural single-lead ST-segment deviation showed better accuracy than residual single-lead ST-segment elevation or resolution and residual 12-lead ST-segment deviation.


CONCLUSIONS
This study showed that maximal residual ST-segment deviation in a single lead at 3 hours after the procedure is an easy and accurate predictor of 1-year mortality after primary angioplasty for STEMI.
De Luca
G
G
Division of Cardiology, Ospedale Maggiore della Caritè, Universitè del Piemonte Orientale A Avogadro, Novara, Italy.
Suryapranata
H
H
Ottervanger
J P
JP
Hoorntje
J C A
JC
Gosselink
A T M
AT
Dambrink
J-H
JH
de Boer
M-J
MJ
van't Hof
A W J
AW
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors