ST segment resolution post MI--a predictor of better outcomes.

OBJECTIVE

To compare, the post Myocardial Infarction in-patient outcome of patients with early ST resolution to those without ST resolution on ECG, in a South Asian population.

METHODS

This was a prospective study done at the Punjab Institute of Cardiology, Lahore. Consecutive patients of ST elevation myocardial infarction, who were not treated with primary angioplasty but were thrombolysed were recruited at the time of arrival in the emergency department. Streptokinase was administered to all patients as the agent of thrombolysis. ECG was acquired at baseline and at 60 minutes post streptokinase administration. Patients were subsequently divided into two groups (A) Patients with ST segment resolution, after 60 minutes of administration of streptokinase (B). Patients without ST segment resolution, after 60 minutes of administration of streptokinase. This cohort was followed up through the in hospital stay for major complications which were recurrent ischaemic chest pain ,heart failure, arrhythmias and death, during the follow up period (Mean stay 3.01+/- 0.77 days).

RESULTS

A total of 148 patients were included in this prospective study. There were 122 males and 26 females. In group A complications developed in 33 (35%) out of 95 patients and 43 (81%) out of 53 patients in group B (p< 0.001). Recurrent chest pain was present in 19 (20%) patients of group A and 31 (59%) patients of group B (p<0.001).Heart failure was the most common complication observed in both groups, 26 (27%) patients in group A and 33 (62%) patients in group B (p<0.001). Arrhythmias were more common in group B, with 17 (32%) patients from group B and 9 (10%) from group A developing this complication (p<0.001).

CONCLUSIONS

The extent of ST segment resolution provides useful information about early clinical outcome in post-myocardial infarction patients.