Prognostic implications of ST-segment elevation resolution in patients with ST-segment elevation acute myocardial infarction treated with primary or facilitated percutaneous coronary intervention.
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.
Palmerini
Tullio
T
Istituto di Cardiologia, Policlinico S. Orsola, Università di Bologna, Bologna, Italy.
De Servi
Stefano
S
Politi
Alessandro
A
Martinoni
Alessandro
A
Musumeci
Giuseppe
G
Ettori
Federica
F
Piccaluga
Emanuela
E
Sangiorgi
Diego
D
Lauria
Giulia
G
Repetto
Alessandra
A
Castiglioni
Battistina
B
Fabbiocchi
Franco
F
Onofri
Marco
M
De Cesare
Nicoletta
N
D'Urbano
Maurizio
M
Poletti
Fabrizio
F
Sangiorgi
Giuseppe
G
Zanini
Roberto
R
Lettieri
Corrado
C
Belli
Guido
G
Pirelli
Salvatore
S
Klugmann
Silvio
S
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