Degree of ST-segment elevation in patients with STEMI reflects the acute ischemic burden and the salvage potential
Research output: Contribution to journal › Journal article › Research › peer-review
Background: ST-segment elevation myocardial infarction (STEMI) is clinically diagnosed by significant ST-segment elevation (STE) in the electrocardiogram (ECG). The importance of the sum of significant ST-segment elevation (∑STE) before primary percutaneous coronary intervention (PPCI) – considered an indicator of the degree of ischemia - is sparse. We evaluated the association of ∑STE before PPCI with respect to area at risk, infarct size and myocardial salvage. Methods: A total of 503 patients with STEMI and available cardiac magnetic resonance (CMR) were included. CMR was performed at day 1 (interquartile range [IQR], 1–1) and at follow-up at day 92 (IQR, 88–96). The ECG before PPCI with the most prominent STE was used for analysis. Results: ∑STE divided into quartiles were progressive linearly associated with area at risk (p < 0.001), final infarct size (p < 0.001) and extent of microvascular obstruction (p < 0.001) and inverse linearly associated with final myocardial salvage (p < 0.001). Similar results were found for linear regression analyses. However, ∑STE was not associated with final myocardial salvage in patients with pre-PCI TIMI (thrombolysis in myocardial infarction) flow 0/1 (p = 0.24) in contrast to patients with pre-PCI TIMI flow 2/3 (p ≤ 0.001). Conclusion: In patients with STEMI presenting within 12 h of symptom onset, the degree of STE in the ECG before PPCI is a marker of the extent of myocardium at risk that in turn affects the infarct size in patients with pre-PCI TIMI flow 0/1, whereas the degree of STE in patients with pre-PCI TIMI flow 2/3 is a marker of the extent of the myocardium at risk as well as myocardial salvage – both affecting the myocardial damage.
Original language | English |
---|---|
Journal | Journal of Electrocardiology |
Volume | 63 |
Pages (from-to) | 28-34 |
Number of pages | 7 |
ISSN | 0022-0736 |
DOIs | |
Publication status | Published - 2020 |
- Area at risk, Electrocardiogram, Magnetic resonance imaging, Myocardial infarction, Percutaneous coronary intervention
Research areas
ID: 260599214