TY - JOUR
T1 - What is the best ST-segment recovery parameter to predict clinical outcome and myocardial infarct size? Amplitude, speed, and completeness of ST-segment recovery after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction
AU - Kuijt, Wichert J.
AU - Green, Cindy L.
AU - Verouden, Niels J.W.
AU - Haeck, Joost D.E.
AU - Tzivoni, Dan
AU - Koch, Karel T.
AU - Stone, Gregg W.
AU - Lansky, Alexandra J.
AU - Broderick, Samuel
AU - Tijssen, Jan G.P.
AU - de Winter, Robbert J.
AU - Roe, Matthew T.
AU - Krucoff, Mitchell W.
N1 - Publisher Copyright:
© 2017
PY - 2017/11
Y1 - 2017/11
N2 - Aims ST-segment recovery (STR) is a strong mechanistic correlate of infarct size (IS) and outcome in ST-segment elevation myocardial infarction (STEMI). Characterizing measures of speed, amplitude, and completeness of STR may extend the use of this noninvasive biomarker. Methods and results Core laboratory continuous 24-h 12-lead Holter ECG monitoring, IS by single-photon emission computed tomography (SPECT), and 30-day mortality of 2 clinical trials of primary percutaneous coronary intervention in STEMI were combined. Multiple ST measures (STR at last contrast injection (LC) measured from peak value; 30, 60, 90, 120, and 240 min, residual deviation; time to steady ST recovery; and the 3-h area under the time trend curve [ST-AUC] from LC) were univariably correlated with IS and predictive of mortality. After multivariable adjustment for ST-parameters and GRACE risk factors, STR at 240 min remained an additive predictor of mortality. Early STR, residual deviation, and ST-AUC remained associated with IS. Conclusions Multiple parameters that quantify the speed, amplitude, and completeness of STR predict mortality and correlate with IS.
AB - Aims ST-segment recovery (STR) is a strong mechanistic correlate of infarct size (IS) and outcome in ST-segment elevation myocardial infarction (STEMI). Characterizing measures of speed, amplitude, and completeness of STR may extend the use of this noninvasive biomarker. Methods and results Core laboratory continuous 24-h 12-lead Holter ECG monitoring, IS by single-photon emission computed tomography (SPECT), and 30-day mortality of 2 clinical trials of primary percutaneous coronary intervention in STEMI were combined. Multiple ST measures (STR at last contrast injection (LC) measured from peak value; 30, 60, 90, 120, and 240 min, residual deviation; time to steady ST recovery; and the 3-h area under the time trend curve [ST-AUC] from LC) were univariably correlated with IS and predictive of mortality. After multivariable adjustment for ST-parameters and GRACE risk factors, STR at 240 min remained an additive predictor of mortality. Early STR, residual deviation, and ST-AUC remained associated with IS. Conclusions Multiple parameters that quantify the speed, amplitude, and completeness of STR predict mortality and correlate with IS.
KW - Continuous ST-segment recovery
KW - Myocardial infarct size
KW - Primary percutaneous coronary intervention
KW - Prognosis
KW - ST-segment elevation myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=85034958358&partnerID=8YFLogxK
U2 - 10.1016/j.jelectrocard.2017.04.009
DO - 10.1016/j.jelectrocard.2017.04.009
M3 - Article
C2 - 29153151
AN - SCOPUS:85034958358
SN - 0022-0736
VL - 50
SP - 952
EP - 959
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 6
ER -