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Worst lead ST deviation and resolution of ST elevation at one hour for prediction of myocardial salvage, infarct size, and microvascular obstruction in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention

Stensjøen, Anne Line ; Hommerstad, Anders ; Halvorsen, Sigrun ; Arheden, Håkan LU ; Engblom, Henrik LU ; Erlinge, David LU orcid ; Larsen, Alf Inge ; Sejersten Ripa, Maria ; Clemmensen, Peter and Atar, Dan , et al. (2020) In Annals of Noninvasive Electrocardiology 25(6).
Abstract

Background: ECG changes after revascularization predicts improved outcome for patients with ST-elevation myocardial infarction (STEMI). Worst lead residual (WLR) ST deviation and resolution of worst lead ST elevation (rST elevation) are simple measures that can be obtained early after PCI. The objective of the current study was to investigate whether simple ECG measures, obtained one hour following PCI, could predict cardiac magnetic resonance (CMR)-derived myocardial salvage index (MSI), infarct size (IS), and microvascular obstruction (MVO) in patients with STEMI included in the MITOCARE trial. Methods: The MITOCARE trial included 165 patients with a first-time STEMI presenting within six hours of symptom onset. The current analysis... (More)

Background: ECG changes after revascularization predicts improved outcome for patients with ST-elevation myocardial infarction (STEMI). Worst lead residual (WLR) ST deviation and resolution of worst lead ST elevation (rST elevation) are simple measures that can be obtained early after PCI. The objective of the current study was to investigate whether simple ECG measures, obtained one hour following PCI, could predict cardiac magnetic resonance (CMR)-derived myocardial salvage index (MSI), infarct size (IS), and microvascular obstruction (MVO) in patients with STEMI included in the MITOCARE trial. Methods: The MITOCARE trial included 165 patients with a first-time STEMI presenting within six hours of symptom onset. The current analysis included patients that had an ECG recorded at baseline and one hour after PCI and underwent CMR imaging after 3–5 days. Independent core laboratories determined WLR ST deviation, rST elevation, and the CMR variables (MSI, IS, and MVO). Results: 83 patients with a mean age of 61 years were included. 83.1% were males and 41% had anterior infarctions. In logistic regression models, WLR ST deviation was a statistically significant predictor of IS (OR 2.2, 95% CI 1.3–3.8) and MVO (OR 2.8, 95% CI 1.5–5.2), but not of MSI (OR 0.8, 95% CI 0.5–1.2). rST elevation showed a trend toward a significant association with IS (OR 0.3, 95% CI 0.1–1.0), but not with the other CMR variables. Conclusion: WLR ST deviation one hour after PCI was a predictor of IS and MVO. WLR ST deviation, a measure easily obtained from ECGs following PCI, may provide important prognostic information in patients with STEMI.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cardiac magnetic resonance, cardiology, electrocardiography, ST-elevation myocardial infarction
in
Annals of Noninvasive Electrocardiology
volume
25
issue
6
article number
e12784
publisher
Wiley-Blackwell
external identifiers
  • scopus:85087295809
  • pmid:32592427
ISSN
1082-720X
DOI
10.1111/anec.12784
language
English
LU publication?
yes
id
2896c9cc-6f68-48ee-9132-d5680c721a52
date added to LUP
2020-07-20 10:22:16
date last changed
2024-05-01 13:59:09
@article{2896c9cc-6f68-48ee-9132-d5680c721a52,
  abstract     = {{<p>Background: ECG changes after revascularization predicts improved outcome for patients with ST-elevation myocardial infarction (STEMI). Worst lead residual (WLR) ST deviation and resolution of worst lead ST elevation (rST elevation) are simple measures that can be obtained early after PCI. The objective of the current study was to investigate whether simple ECG measures, obtained one hour following PCI, could predict cardiac magnetic resonance (CMR)-derived myocardial salvage index (MSI), infarct size (IS), and microvascular obstruction (MVO) in patients with STEMI included in the MITOCARE trial. Methods: The MITOCARE trial included 165 patients with a first-time STEMI presenting within six hours of symptom onset. The current analysis included patients that had an ECG recorded at baseline and one hour after PCI and underwent CMR imaging after 3–5 days. Independent core laboratories determined WLR ST deviation, rST elevation, and the CMR variables (MSI, IS, and MVO). Results: 83 patients with a mean age of 61 years were included. 83.1% were males and 41% had anterior infarctions. In logistic regression models, WLR ST deviation was a statistically significant predictor of IS (OR 2.2, 95% CI 1.3–3.8) and MVO (OR 2.8, 95% CI 1.5–5.2), but not of MSI (OR 0.8, 95% CI 0.5–1.2). rST elevation showed a trend toward a significant association with IS (OR 0.3, 95% CI 0.1–1.0), but not with the other CMR variables. Conclusion: WLR ST deviation one hour after PCI was a predictor of IS and MVO. WLR ST deviation, a measure easily obtained from ECGs following PCI, may provide important prognostic information in patients with STEMI.</p>}},
  author       = {{Stensjøen, Anne Line and Hommerstad, Anders and Halvorsen, Sigrun and Arheden, Håkan and Engblom, Henrik and Erlinge, David and Larsen, Alf Inge and Sejersten Ripa, Maria and Clemmensen, Peter and Atar, Dan and Hall, Trygve S.}},
  issn         = {{1082-720X}},
  keywords     = {{cardiac magnetic resonance; cardiology; electrocardiography; ST-elevation myocardial infarction}},
  language     = {{eng}},
  number       = {{6}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Annals of Noninvasive Electrocardiology}},
  title        = {{Worst lead ST deviation and resolution of ST elevation at one hour for prediction of myocardial salvage, infarct size, and microvascular obstruction in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention}},
  url          = {{http://dx.doi.org/10.1111/anec.12784}},
  doi          = {{10.1111/anec.12784}},
  volume       = {{25}},
  year         = {{2020}},
}