Clinical implications of serial changes in ST-segment elevation after reperfusion in patients with anterior acute myocardial infarction.
BACKGROUND
In patients with acute myocardial infarction (AMI), the relationship of serial changes in ST-segment elevation after reperfusion to left ventricular (LV) function remains unclear.


RESULTS
The study group comprised 164 patients with reperfused anterior AMI within 6 h of symptom onset. The sum of ST-segment deviation was calculated on admission (SigmaST-admission), and 1 h (SigmaST-1 h) and 24 h (SigmaST-24 h) after reperfusion. ST resolution was defined as a reduction in SigmaST-1 h of > or =50% as compared with SigmaST-admission. Patients were classified into 3 groups: group A, 82 patients with ST resolution in whom SigmaST-1 h > or = SigmaST-24 h; group B, 37 patients with ST resolution in whom SigmaST-1 h < SigmaST-24 h; group C, 45 patients without ST resolution. Peak creatine kinase were higher in groups B and C than in group A (4,578+/-2,176, 4,236+/-2,638, 2,222+/-1,926 mU/ml, p<0.01). At 6 months follow-up, the LV ejection fraction were lower in groups B and C than in group A (53+/-8, 54+/-12, 62+/-9%, p<0.01).


CONCLUSIONS
An increase in ST-segment elevation 1-24 h after reperfusion, despite ST resolution, is associated with a larger infarction and poorer LV function in patients with reperfused anterior AMI.
Okuda
Jun
J
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Kosuge
Masami
M
Ebina
Toshiaki
T
Hibi
Kiyoshi
K
Tsukahara
Kengo
K
Iwahashi
Noriaki
N
Endo
Mitsuaki
M
Nakachi
Tatsuya
T
Mitsuhashi
Takayuki
T
Otsuka
Fumiyuki
F
Kusama
Ikuyoshi
I
Hashiba
Katsutaka
K
Komura
Naohiro
N
Umemura
Satoshi
S
Kimura
Kazuo
K
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*; D015425:Myocardial Reperfusion; D011237:Predictive Value of Tests; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
D002097:C-Reactive Protein; D003402:Creatine Kinase