Postprocedural single-lead ST-segment deviation and long-term mortality in patients with ST-segment elevation myocardial infarction treated by primary angioplasty.

OBJECTIVE

To evaluate the prognostic role of postprocedural single-lead residual ST-segment deviation for electrocardiographic evaluation of myocardial perfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary angioplasty.

DESIGN

Prospective observational clinical cohort study.

SETTING

Tertiary referral centre.

PATIENTS

1660 patients treated with primary angioplasty for STEMI.

MAIN OUTCOME MEASURE

Mortality at 1-year follow-up.

RESULTS

Single-lead ST-segment deviation significantly correlated with infarct size, predischarge ejection fraction, distal embolisation and myocardial blush grade 3. At 1-year follow-up, 63 patients had died. The method correlated well with 1-year mortality. At multivariate analysis, after correction for baseline demographic, clinical and angiographic variables, postprocedural single-lead ST-segment deviation showed better accuracy than residual single-lead ST-segment elevation or resolution and residual 12-lead ST-segment deviation.

CONCLUSIONS

This study showed that maximal residual ST-segment deviation in a single lead at 3 hours after the procedure is an easy and accurate predictor of 1-year mortality after primary angioplasty for STEMI.