Copyright © 2003 by the European Society of Cardiology.
Prognostic value of ST-segment resolution—when and what to measure
a Clinical Experimental Research Laboratory, Sahlgrenska University Hospital/Östra, SE-41685 Göteborg, Sweden
b Department of Cardiology, University Hospital Uppsala, Uppsala, Sweden
Received August 21, 2002;
accepted October 9, 2002
* Corresponding author. Tel: +46-31-343-4000; fax: +46-31-191416
pj{at}hjl.gu.se
Aims Analyses of ST-segment resolution during acute myocardial infarction has, during recent years, challenged coronary angiography as gold-standard for predictingmyocardial reflow and future risk. We have previously reported that continuous ST-monitoring can be done accurately in the clinical setting. We now set out to compare the prognostic value of previously suggested cut-offs for ST-segmentresolution, and determine the times to measure these.
Methods and results We analysed 752 patients with ST-elevation infarction, from the second Assessment of Safety and Efficacy of a New Thrombolytic (ASSENT 2) and ASSENT-PLUS studies, either with vectorcardiography or continuous 12-lead ST-monitoring. All analyses were made blindly by two independent observers. Times to 20, 30, 50 and 70% ST-segment resolution were examined in relation to 30-day mortality.
The optimal cut-off for ST-segment resolution analyses was found to be 50%, measured at 60min. We could hereby identify a large low-risk group, 40% of the population, with only 1.4% 30-day mortality. Furthermore, 88% of deaths were correctly predicted within 1h of observation and treatment.
Conclusion Continuous ST-monitoring of patients with acute myocardial infarction yields important prognostic information after 60min of observation and should be used for very early-risk stratification in these patients.
Key Words: Acute myocardial infarction • Prognosis • Electrocardiography
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. G. Masci, J. Ganame, E. Strata, W. Desmet, G. D. Aquaro, S. Dymarkowski, V. Valenti, S. Janssens, M. Lombardi, F. Van de Werf, et al. Myocardial Salvage by CMR Correlates With LV Remodeling and Early ST-Segment Resolution in Acute Myocardial Infarction J. Am. Coll. Cardiol. Img., January 1, 2010; 3(1): 45 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kempf, E. Bjorklund, S. Olofsson, B. Lindahl, T. Allhoff, T. Peter, J. Tongers, K. C. Wollert, and L. Wallentin Growth-differentiation factor-15 improves risk stratification in ST-segment elevation myocardial infarction Eur. Heart J., December 1, 2007; 28(23): 2858 - 2865. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E Bjorklund, T Jernberg, P Johanson, P Venge, M Dellborg, L Wallentin, B Lindahl, and the ASSENT-2 and ASSENT-PLUS Study Groups Admission N-terminal pro-brain natriuretic peptide and its interaction with admission troponin T and ST segment resolution for early risk stratification in ST elevation myocardial infarction Heart, June 1, 2006; 92(6): 735 - 740. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Johanson, Y. Fu, S. G. Goodman, M. Dellborg, P. W. Armstrong, M. W. Krucoff, L. Wallentin, and G. S. Wagner A dynamic model forecasting myocardial infarct size before, during, and after reperfusion therapy: an ASSENT-2 ECG/VCG substudy Eur. Heart J., September 1, 2005; 26(17): 1726 - 1733. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. W. Krucoff, P. Johanson, R. Baeza, S. W. Crater, and M. Dellborg Clinical Utility of Serial and Continuous ST-Segment Recovery Assessment in Patients With Acute ST-Elevation Myocardial Infarction: Assessing the Dynamics of Epicardial and Myocardial Reperfusion Circulation, December 21, 2004; 110(25): e533 - e539. [Full Text] [PDF]
|
|
|
|
|
|
E. Bjorklund, B. Lindahl, P. Johanson, T. Jernberg, A.-M. Svensson, P. Venge, L. Wallentin, M. Dellborg, and the ASSENT-2 and ASSENT-PLUS study groups Admission Troponin T and measurement of ST-segment resolution at 60 min improve early risk stratification in ST-elevation myocardial infarction Eur. Heart J., January 2, 2004; 25(2): 113 - 120. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 ST-Segment Resolution Predicts Low Mortality in STEMI Patients Journal Watch Emergency Medicine, May 14, 2003; 2003(514): 3 - 3. [Full Text]
|
|