ST-segment depression resolution predicts infarct size and reperfusion injury in ST-elevation myocardial infarction

Reinstadler, Sebastian Johannes; Baum, Anett; Rommel, Karl‐Philipp; Eitel, Charlotte; Desch, Steffen; Mende, Meinhard; Metzler, Bernhard; Poess, Janine; Thiele, Holger; Eitel, Ingo

doi:10.1136/heartjnl-2015-307876

Cited by 29 publications

(18 citation statements)

References 27 publications

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“…After being adjusted to other variable affecting MACEs in 30 days after myocardial infarction, resolution in reciprocal STSD is proven dominant in predicting MACEs. This is consistent with studies done by Tjandrawidjaja et al, 2010 31 ; Wong et al, 2015 32 ; and Reinstadler et al, 2015 33 . Which stated that absence of resolution in STSD is associated with higher rate of MACEs in reperfused STEMI patients.…”

Section: Discussionsupporting

confidence: 92%

Resolution of Reciprocal ST Segment Depression as Predictor for Major Cardiovascular Events in Stemi Patients Treated with Alteplase

Adhitya¹,

Hasan²,

Sitepu³

et al. 2018

IJPTR

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Background: ST Elevation Myocardial Infarction (STEMI) may cause Major Cardiovascular Events (MACEs). Revascularization needs to be done in all STEMI patients to restore coronary blood flow, hence saving myocardial perfusion. Reciprocal ST Segment Depression (STSD) is associated with poor prognosis in STEMI patients receiving fibrinolytic therapy. The main purpose of this study is to evaluate MACE in STEMI patients receiving alteplase as fibrinolytic therapy using resolution in STSD. Methods: This cohort prospective study with 60 subjects of STEMI patients which are evaluated for MACEs (death, heart failure, and rehospitalization) within 30 days after myocardial infarction. Resolution in reciprocal STSD is defined as resolution ≥ 50% STSD in reciprocal leads within 90 minutes after fibrinolytic therapy. Results: Bivariate analysis showed that Ejection fraction (EF) <40% with OR 8,32 (2,11-32,74), p=0,001; smoking with OR 4,17 (1,05-16,57), p=0,034; Anterior STEMI with OR 3,94 (1,(11)(12)(13)90), p= 0,027; Creatinine > 1,97 mg/dl with OR 3,69 (1,18-11,55), p= 0,022; complete outpatient medication with OR 5,23 (1,61-17,01), p= 0,004; fragmented QRS with OR 5,23 (1,61-17,01), p= 0,001; resolution in STSD with OR 26,35 (5, 40), p=<0,001; resolution in ST Segment Elevation with OR 10,5 (2,24), p=<0,001; are proven to be determining factor for MACE within 30 days. Multivariate analysis showed that among those determining factors for MACEs, resolution in STSD in reciprocal leads is evidently the most dominant factor for predicting MACEs within 30 days in STEMI patients receiving fibrinolytic therapy .10), p=0.038]. Conclusion: There is significant difference in MACEs within 30 days after myocardial infarction (MI) between patients with and without resolution in STSD. The subjects without resolution in STSD showed higher MACEs incidence. Resolution in STSD is evidently an independent predictor for MACEs within 30 days after myocardial infarction in STEMI patients.

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Section: Discussionsupporting

confidence: 92%

Resolution of Reciprocal ST Segment Depression as Predictor for Major Cardiovascular Events in Stemi Patients Treated with Alteplase

Adhitya¹,

Hasan²,

Sitepu³

et al. 2018

IJPTR

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“…Cine CMR sequences were applied to determine LV mass, volumes and function. IS and MVO obstruction were measured from contrast‐enhanced sequences . T2‐weighted images served to determine the area at risk (AAR) and consequently the myocardial salvage index (MSI) .…”

Section: Methodsmentioning

confidence: 99%

Relationship between diabetes and ischaemic injury among patients with revascularized ST‐elevation myocardial infarction

Reinstadler

Stiermaier

Eitel

et al. 2017

Diabetes Obesity Metabolism

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“…[13][14][15][16][17][18][19] In the present study, we therefore sought to explore the relationship of the admission shock index with myocardial damage as visualized by CMR, and to determine the prognostic value of the shock index in a large multicenter cohort of STEMI patients.…”

Section: Cmr Imagingmentioning

confidence: 99%

Shock Index as a Predictor of Myocardial Damage and Clinical Outcome in ST-Elevation Myocardial Infarction

Reinstadler

Fuernau

Eitel

et al. 2016

Circ J

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Background: Data on the prognostic value of the shock index in patients with ST-elevation myocardial infarction (STEMI) are scarce. Furthermore, the relationship of the shock index with myocardial damage is unknown. The aim of this study was to evaluate the association of the shock index with markers of myocardial damage and clinical outcome in patients with STEMI. Methods and Results:This multicenter study analyzed 791 patients. Patients were categorized in 2 groups according to the admission shock index (optimized cut-off=0.62). Infarct severity was determined by cardiac magnetic resonance (CMR) imaging. Patients with cardiogenic shock that were unable to undergo CMR acquisition were excluded. Major adverse cardiac events (MACE) were defined as a composite of death, reinfarction and congestive heart failure within 12 months. Patients with elevated admission shock index (n=321 [40.6%]) had a significantly larger area-at-risk (37. Conclusions: STEMI patients with an elevated admission shock index had more pronounced myocardial and microvascular damage. Moreover, the shock index was independently associated with MACE at 12 months. (Circ J 2016; 80: 924 -930)

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ST-segment depression resolution predicts infarct size and reperfusion injury in ST-elevation myocardial infarction

Abstract: Patients with acute STEMI and worsened or incomplete STD-R after PCI show a more pronounced myocardial as well as microvascular damage as detected by CMR with subsequent independent prognostic information on MACE over a 12-month follow-up period.

Cited by 29 publications

References 27 publications

Resolution of Reciprocal ST Segment Depression as Predictor for Major Cardiovascular Events in Stemi Patients Treated with Alteplase

Resolution of Reciprocal ST Segment Depression as Predictor for Major Cardiovascular Events in Stemi Patients Treated with Alteplase

Relationship between diabetes and ischaemic injury among patients with revascularized ST‐elevation myocardial infarction

Shock Index as a Predictor of Myocardial Damage and Clinical Outcome in ST-Elevation Myocardial Infarction

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