title: The relationship between Gensini score and ST-segment resolution in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: BACKGROUND
  Clinical outcomes of patients with myocardial infarction are primarily determined by the successful restoration of myocardial reperfusion and the severity of coronary atherosclerosis.
  
  
  OBJECTIVE
  To investigate the predictive value of Gensini score on ST-segment resolution (STR) in patients undergoing primary percutaneous coronary intervention (pPCI) for acute ST-elevation myocardial infarction (STEMI).
  
  
  METHODS
  The present study prospectively included 114 consecutive patients (mean age 54 ± 10 years, 15 women) with STEMI who underwent successful pPCI. Sum of ST-segment elevation amount in millimetres was obtained before angioplasty and 60 min after pPCI. ΣSTR < 50% was accepted as a ECG sign of no-reflow phenomenon. Thrombus grading was calculated according to the results of coronary angiography, and Gensini score (GS-pPCI) was calculated after pPCI without incorporating culprit lesion. Patients were divided into two groups according to STR: those with STR(-), and those with STR(+). Patients were also analysed according to the infarct-related artery.
  
  
  RESULTS
  GS-pPCI was significantly higher in patients with STR(-) (10.1 ± 11.8 vs. 22 ± 18.6, p = 0.005). GS-pPCI was inversely correlated with STR (r = -0.287, p = 0.002). In subgroup analysis, patients in the STR(-) group with culprit lesion in left anterior descending artery and left circumflex artery also showed higher GS-pPCI (10.9 ± 13.5 vs. 23.5 ± 21.3, p = 0.03 and 9.6 ± 8.7 vs. 24.1 ± 21, p = 0.04, respectively). High thrombus burden was also observed more frequently in patients with STR(-) (68% vs. 43%, p = 0.03). Multivariate logistic regression analysis demonstrated that GS-pPCI and high thrombus burden independently predicted inadequate STR (OR 1.07, 95% CI 1.03-1.12, p = 0.001 and OR 3.28, 95% CI1.11-9.72, p = 0.03, respectively).
  
  
  CONCLUSIONS
  GS-pPCI and high thrombus burden play an important role in predicting inadequate STR in patients with STEMI treated with pPCI.
authors.forename: Aycan Esen
authors.initials: AE
authors.lastname: Zencirci
authors.affiliation: Department of Cardiology, Acıbadem Maslak Hospital. aycanesen@hotmail.com.
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Zencirci
authors.forename: Aleks
authors.initials: A
authors.lastname: Degirmencioglu
authors.forename: Gultekin
authors.initials: G
authors.lastname: Karakus
authors.forename: Murat
authors.initials: M
authors.lastname: Ugurlucan
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Gunduz
authors.forename: Kivilcim
authors.initials: K
authors.lastname: Ozden
authors.forename: Aysun
authors.initials: A
authors.lastname: Erdem
authors.forename: Fatma
authors.initials: F
authors.lastname: Karadeniz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ekmekci
authors.forename: Hatice
authors.initials: H
authors.lastname: Erer
authors.forename: Nurten
authors.initials: N
authors.lastname: Sayar
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
mesh_terms: D000328:Adult; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome