title: Prognostic implications of ST-segment elevation resolution in patients with ST-segment elevation acute myocardial infarction treated with primary or facilitated percutaneous coronary intervention.
abstract: Scant data are available on the relation between ST-segment elevation (STE) resolution and 30-day mortality in patients with STE acute myocardial infarction treated with percutaneous coronary intervention in contemporary, real world, clinical practice. Furthermore, whether the prognostic value of STE resolution is influenced by the patient clinical risk profile or postprocedural Thrombolysis In Myocardial Infarction (TIMI) flow has never been investigated. Lombardima was an observational registry implemented in Lombardy, a Northern Italian region. The clinical characteristics, electorcardiographic parameters, and procedural data were prospectively entered into a Web-based database. In the present study, we enrolled 3,403 patients. STE resolution occurred in 2,452 patients (group 1) and did not in 951 patients (group 2). The mortality rate was 2.4% in group 1 and 11.3% in group 2 (p <0.001). After stratifying patients according to their TIMI risk index, we observed that STE resolution was an independent predictor of 30-day mortality across all spectrum of clinical risk. Furthermore, in patients with TIMI 3 flow, STE resolution remained an independent predictor of 30-day mortality (p <0.0001). In conclusion, STE resolution was a strong and independent predictor of 30-day mortality in patients with STE acute myocardial infarction undergoing percutaneous coronary intervention across all spectrum of clinical risk.
authors.affiliation: Istituto di Cardiologia, Policlinico S. Orsola, Università di Bologna, Bologna, Italy.
authors.forename: Tullio
authors.initials: T
authors.lastname: Palmerini
authors.forename: Stefano
authors.initials: S
authors.lastname: De Servi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Politi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Martinoni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Musumeci
authors.forename: Federica
authors.initials: F
authors.lastname: Ettori
authors.forename: Emanuela
authors.initials: E
authors.lastname: Piccaluga
authors.forename: Diego
authors.initials: D
authors.lastname: Sangiorgi
authors.forename: Giulia
authors.initials: G
authors.lastname: Lauria
authors.forename: Alessandra
authors.initials: A
authors.lastname: Repetto
authors.forename: Battistina
authors.initials: B
authors.lastname: Castiglioni
authors.forename: Franco
authors.initials: F
authors.lastname: Fabbiocchi
authors.forename: Marco
authors.initials: M
authors.lastname: Onofri
authors.forename: Nicoletta
authors.initials: N
authors.lastname: De Cesare
authors.forename: Maurizio
authors.initials: M
authors.lastname: D'Urbano
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Poletti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sangiorgi
authors.forename: Roberto
authors.initials: R
authors.lastname: Zanini
authors.forename: Corrado
authors.initials: C
authors.lastname: Lettieri
authors.forename: Guido
authors.initials: G
authors.lastname: Belli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pirelli
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome