Koivula Kimmo, Eskola Markku, Viikilä Juho, Lilleberg Jyrki, Huhtala Heini, Birnbaum Yochai, Nikus Kjell
Internal medicine, Helsinki University Hospital, Finland; Faculty of Medicine and Life Sciences, University of Tampere, Finland.
Faculty of Medicine and Life Sciences, University of Tampere, Finland; Heart Center, Department of Cardiology, Tampere University Hospital, Finland.
J Electrocardiol. 2018 Jul-Aug;51(4):598-606. doi: 10.1016/j.jelectrocard.2018.03.014. Epub 2018 Apr 4.
Grade 3 ischemia (G3I) in the 12‑lead electrocardiogram (ECG) predicts poor outcome in patients with ST-elevation myocardial infarction (STEMI). The outcome of G3I in "real-life" patient cohorts is unclear.
The aim of the study was to establish the prognostic significance of grade 2 ischemia (G2I), G3I and the STEMI patients excluded from ischemia grading (No grade of ischemia, NG) in a real-life patient population. We assessed in-hospital, 30-day and 1-year mortality as well as other endpoints.
The NG patients had more comorbidities and longer treatment delays than the two other groups. Short-term and 1-year mortality were highest in patients with NG and lowest in patients with G2I. Maximum troponin level was highest in G3I, followed by NG and G2I. In logistic regression multivariable analysis, NG was independently associated with 1-year mortality.
NG predicted poor outcome in STEMI patients. G2I predicted relatively favorable outcome.
12导联心电图（ECG）中的3级缺血（G3I）预示着ST段抬高型心肌梗死（STEMI）患者的不良预后。“真实世界”患者队列中G3I的预后尚不清楚。
本研究的目的是确定在真实世界患者群体中2级缺血（G2I）、G3I以及未进行缺血分级的STEMI患者（无缺血分级，NG）的预后意义。我们评估了住院期间、30天和1年死亡率以及其他终点。
与其他两组相比，NG患者有更多的合并症且治疗延迟更长。NG患者的短期和1年死亡率最高，G2I患者最低。肌钙蛋白最高水平在G3I中最高，其次是NG和G2I。在逻辑回归多变量分析中，NG与1年死亡率独立相关。
NG预示着STEMI患者的不良预后。G2I预示着相对较好的预后。
