Incidence and significance of spontaneous ST segment re-elevation after reperfused anterior acute myocardial infarction: Relationship with infarct size, adverse remodeling and events at 1 year

Cuenin, Léo; Mewton, Nathan; Ovize, Michel; Lamoureux, Sylvie; Schaaf, Mathieu; Bonnefoy‐Cudraz, Eric

doi:10.1016/j.acvdsp.2017.11.029

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…The author received remuneration from Abbott Vascular, Kaneka, Daiichisankyo, and Terumo. thrombosis and pericarditis were present in 0.8 and 9.4% of cases, respectively, in the report by Cuenin et al 8 It is noteworthy that their results were similar after exclusion of all patients with stent thrombosis and pericarditis. As discussed by Cuenin et al, infarct expansion, reperfusion injury, inflammatory response, and edema may play a role in ST re-elevation.…”

Section: Conflicts Of Interestmentioning

confidence: 70%

Is There Any Impact of ST Re-elevation on Patients With Acute Myocardial Infarction Following Reperfusion Therapy?

Tanabe

2018

Circ J

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re-elevation, despite initial ST resolution, occurred in 23% of the patients, and was associated with poorer EF at 6 months. They divided their patients into 3 groups (ST resolution without re-elevation, ST resolution with reelevation, and no ST resolution), and showed the serial ECG changes (Figure). In this issue of the Journal, Cuenin et al 8 report that 19% of 662 patients experienced ST segment re-elevation, but there were no differences in EF or death at 1 year between patients with and without re-elevation. Although the incidence of ST re-elevation was similar to that reported by Okuda et al, the effect on EF was inconsistent. Several differences between the 2 studies may have influenced the results. First, the timing of evaluation for ST re-elevation was different. Most previous studies evaluated ST resolution within several hours after reperfusion therapy, and ST resolution was consistently associated with better clinical outcomes. The mechanism of ST re-elevation is unclear and its occurrence suggests the possibility of re-infarction or pericarditis. In fact, stent P rimary percutaneous coronary intervention (PCI) to recanalize an occluded artery has been the main treatment for acute myocardial infarction (AMI), but a substantial number of patients still develop large infarcts. Impaired microvascular reperfusion, which is evaluated by the absence of resolution of ST-segment elevation (ST resolution) on the 12-lead ECG following reperfusion therapy, is considered to be associated with worse final TIMI (Thrombolysis in Myocardial Infarction) flow grade and large infarcts. 1 Furthermore, the measure of ST resolution has been reported to correlate with left ventricular function, survival, and reinfarction during longterm follow-up after both primary PCI and thrombolytic therapy. 1-7 ST resolution occurs in 64-85% of patients, as shown in the Table. Only a few previous reports have investigated the prevalence of ST segment re-elevation even though ECG is a standard and simple diagnostic modality. Matano et al reported that ST re-elevation occurred in 29% of the patients, but that there was no difference in ejection fraction (EF) at 1 month between the patients with and without ST re-elevation. 4 In contrast, Okuda et al 6 reported that ST

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Section: Conflicts Of Interestmentioning

confidence: 70%

Is There Any Impact of ST Re-elevation on Patients With Acute Myocardial Infarction Following Reperfusion Therapy?

Tanabe

2018

Circ J

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“…17 The absence of ST resolution was poor prognostic factor after primary PCI, but complete resolution of the ST elevation was associated with an increased risk of ST elevation at the time of discharge. 18 The complete resolution (≥ 70%) of the ST elevation, 60 minutes after PCI, was associated with greater reduction of MACE; however, the presence of diabetes mellitus and delay in reaching the hospital were deleterious to reperfusion. 19 Distortion of the terminal portion of the QRS was associated with cardiac dysfunction.…”

Section: Pharmacoinvasive Therapymentioning

confidence: 92%

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

Rangel¹

2021

International Journal of Cardiovascular Sciences

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ST elevation myocardial infarction (STEMI) is a highly prevalent condition worldwide. Reperfusion therapy is strongly associated with the prognosis of STEMI and must be performed with a high standard of quality and without delay. A systematic review of different reperfusion strategies for STEMI was conducted, including randomized controlled trials that included major cardiovascular events (MACE), and systematic reviews in the last 5 years through the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) methodology. The research was done in the PubMed and Cochrane Central Register of Controlled Trials databases, in addition to a few manual searches. After the exclusion criteria were applied, 90 articles were selected for this review. Despite the reestablishment of IRA patency in PCI for STEMI, microvascular lesions occur in a significant proportion of these patients, which can compromise ventricular function and clinical course. Several therapeutic strategies -intracoronary administration of nicorandil, nitrates, melatonin, antioxidant drugs (quercetin, glutathione), antiinflammatory substances (tocilizumab [an inhibitor of interleukin 6], inclacumab, P-selectin inhibitor), immunosuppressants (cyclosporine), erythropoietin and ischemic pre-and post-conditioning and stem cell therapy -have been tested to reduce reperfusion injury, ventricular remodeling and serious cardiovascular events, with heterogeneous results: These therapies need confirmation in larger studies to be implemented in clinical practice PrevalenceThe worldwide prevalence of ischemic heart disease is approximately 111 million cases, with 7.3 million cases of fatal acute myocardial infarction (AMI) in 2015. The inadequate treatment of patients with AMI is associated with significant increases in morbidity and mortality. 1 ObjectivesThe objective of this systematic review is to evaluate the evidence of different reperfusion therapies in STsegment elevation AMI (STEMI), selecting mainly randomized controlled trials and systematic reviews that address major cardiovascular clinical outcomes. MethodsThe review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched the PubMed database for the terms "acute myocardial infarction" and "reperfusion therapy", which yielded 9,885 results. After applying the following search filters -type of abstract: "text and full text"; type of article: "metaanalysis, review, systematic review and randomized clinical trial", and date of publication: "last 5 years", and language: "English" -127 articles were obtained. In addition, research was conducted at the Cochrane Central Register of Controlled Trials using the terms "acute myocardial infarction" and "reperfusion therapy", in English, between 2018 and 2020, which revealed 64 clinical trials, already excluding duplicates. Of the 191

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Incidence and significance of spontaneous ST segment re-elevation after reperfused anterior acute myocardial infarction: Relationship with infarct size, adverse remodeling and events at 1 year

Cited by 2 publications

References 21 publications

Is There Any Impact of ST Re-elevation on Patients With Acute Myocardial Infarction Following Reperfusion Therapy?

Is There Any Impact of ST Re-elevation on Patients With Acute Myocardial Infarction Following Reperfusion Therapy?

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

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