Background: Patients with successful reperfusion and preserved left ventricular
ejection fraction (LVEF) after ST‐segment myocardial infarction (STEMI)have always
been thought to have low risk for adverse events. Great interest is focused on finding
simple, noninvasive tools to refine risk stratification among them.
Objectives: We hypothesized that degree of ST‐segment resolution (STR) after
STEMI can identify high‐risk group among patients with LVEF ≥ 50% following
STEMI.
Methods: During the period from January to July 2017, patients with successful reperfusion
of STEMI and LVEF ≥ 50% were prospectively included. Patients were divided
into two groups based on the percent of ST segment resolution using single
lead STR method; group I (complete STR ≥ 70%) and group II (partial STR 50%–70%).
The endpoint was a composite of cardiovascular mortality, re‐hospitalization for
heart failure and urgent revascularization at 30‐day.
Results: After exclusion, 110 patients were left for final analysis. No significant differences
in all baseline characteristics were found between both groups. The primary
endpoint occurred in seven patients (12.7%) of group I versus 17 patients (30.9%) of
group II (Relative risk = 2.43, 95%CI = 1.1–5.4, p = 0.021) driven by a significant reduction
in rates of re‐hospitalization due to heart failure. A multivariate logistic regression
analysis showed incomplete STR to be a significant independent predictor
for 30‐dayMACEs (OR 3.25, 95% CI1.2–8.83, p = 0.02) even after adjustment for location
of infarction.
Conclusion: Complete STR predicts 30‐day outcome in patients with preserved LVEF
following successful reperfusion of STEMI. |
