Ghaffari Samad, Kolahdouzan Kasra, Rahimi Mehran, Tajlil Arezou
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Int J Gen Med. 2020 Jun 8;13:271-279. doi: 10.2147/IJGM.S258573. eCollection 2020.
ST depression resolution (STD-R) in ECG is a prognostic factor indicative of successful fibrinolysis or angioplasty in the treatment of ST elevation myocardial infarction (STEMI) and subsequent mortality. We conducted this study to determine the clinical significance of STD-R and its predictors in patients with anterior STEMI undergoing primary percutaneous intervention (PPCI).
Admission documents of all patients with diagnosis of anterior STEMI who were admitted to a specialty heart center and underwent PPCI since July 2018 until July 2019 were examined. The amount of ST elevation and depression in all 12 leads of a standard ECG at admission and 90 minutes after PPCI was measured and resolution was determined. All patients were followed-up for 10.8±4.0 months.
A total of 179 patients had ST depression besides elevation in the first ECG. Female gender, diabetes, not smoking, lower hemoglobin, and higher platelet counts were significantly more common in the group with less than 50% resolution of ST depression. STD-R <50% was significantly associated with the incidence of in-hospital acute heart failure and major adverse cardiac events (MACE) (p value: 0.025 and 0.012, respectively) and resolution of ST elevation ≥50% was associated with reduced in-hospital mortality (p value <0.0001). According to Kaplan-Meier curve, survival in the two groups of STE-R ≥50% and STE-R <50% was significantly different (Log rank: 31.18, p value<0.0001).
STD-R can be considered to have high predictive power, like STE-R for predicting incidence of in-hospital acute heart failure and major adverse cardiac events.
心电图ST段压低的恢复（STD-R）是一个预后因素，可指示ST段抬高型心肌梗死（STEMI）治疗中纤溶或血管成形术是否成功以及后续死亡率。我们开展这项研究以确定STD-R及其预测因素在接受直接经皮冠状动脉介入治疗（PPCI）的前壁STEMI患者中的临床意义。
检查自2018年7月至2019年7月入住一家专业心脏中心并接受PPCI的所有诊断为前壁STEMI患者的入院文件。测量入院时标准心电图所有12导联以及PPCI后90分钟时的ST段抬高和压低程度，并确定恢复情况。所有患者随访10.8±4.0个月。
共有179例患者在首次心电图检查时除ST段抬高外还存在ST段压低。ST段压低恢复低于50%的组中，女性、糖尿病、不吸烟、血红蛋白较低以及血小板计数较高的情况明显更为常见。STD-R <50%与院内急性心力衰竭和主要不良心脏事件（MACE）的发生率显著相关（p值分别为0.025和0.012），而ST段抬高恢复≥50%与院内死亡率降低相关（p值<0.0001）。根据Kaplan-Meier曲线，STE-R≥50%和STE-R<50%两组的生存率有显著差异（对数秩检验：31.18，p值<0.0001）。
与STE-R一样，STD-R在预测院内急性心力衰竭和主要不良心脏事件的发生率方面可被认为具有较高的预测能力。
