当前位置:循环首页>正文

HORIZONS-AMI:基线心电图对应导联ST段压低、血管造影发现与直接PCI 的STEMI患者的临床结果之间的相关性

Correlations Between Reciprocal ST-segment Depression on the Baseline Electrocardiogram, Angiographic Findings and Clinical Outcomes in Patients With STEMI Treated With Primary PCI

作者:国际循环网   日期:2010/12/8 10:43:45

国际循环网版权所有,谢绝任何形式转载,侵犯版权者必予法律追究。

Objective - To investigate correlations between reciprocal ST-segment depression on the baseline ECG, angiographic findings and clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).

    Michael E Farkouh1; Eugenia Nikolsky2; James Reiffel3; Ovidiu Dressler4; David A Baran5; Roxana Mehran6; Alexandra J Lansky6; Gregg W Stone6
    1 Mount Sinai Sch of Medicine, New York, NY
    2 Cardiovascular Rsch Foundation, New York, NY
    3 Columbia Univ Med Cntr/Cardiovascular Rsch Foundation, New York, NY
    4 Cardiovascular Rsch Foundation, New York, NY
    5 Newark Beth Israel Med Cntr, Newark, NJ
    6 Columbia Univ Med Cntr/Cardiovascular Rsch Foundation, New York, NY 
    Objective - To investigate correlations between reciprocal ST-segment depression on the baseline ECG, angiographic findings and clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). 
    Methods - Among 3602 pts enrolled in the prospective, randomized Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, 2401 pts had the baseline ECG analyzed by an independent ECG core lab as part of a formal substudy. Reciprocal ST-segment depression defined as >0.1 mV depression in  1 adjacent leads in a territory remote from the site of ST-segment elevation was present in 1559 (64.9%) pts. Patients with posterior infarction were excluded. Angiographic analysis was performed by independent angiographic core lab.
    Results - Reciprocal ST-segment depression on baseline ECG correlated with higher incidence of non-LAD infarct vessel (72.2% vs. 37.9%), baseline TIMI flow grade 0/1 (67.6% vs. 57.3%), higher incidence of thrombus on baseline angiogram (84.3% vs. 75.2%), larger reference vessel diameter (median: 2.9 vs. 2.8 mm) and shorter time from symptoms onset to 1st balloon inflation (median: 215.0 vs. 234.0 min) [all p<0.0001] but not with incidence of multivessel disease (58.4% vs. 54.7%, p=0.08) or lower baseline LVEF (median: 60.2% vs. 59.6%, p=0.55). Clinical outcomes are presented in the Table. By multivariable analysis, baseline reciprocal ST-segment depression was not predictive of mortality at 30 days (hazard ratio [95%CI] = 1.00 [0.38, 2.66], p=0.99) or at 1 year (hazard ratio [95%CI] = 1.00 [0.47, 2.16], p=0.99).
    Conclusion - Reciprocal ST-segment depression on the presenting ECG does not predict an adverse prognosis in patients with STEMI treated by primary PCI and is not correlated with multivessel disease or more extensive myocardial damage as assessed by LVEF.

 

 

版面编辑:沈会会  责任编辑:张衡



HORIZONS-AMI急性心肌梗死血管造影直接PCI

分享到: 更多


设为首页 | 加入收藏 | 关于我们 | 联系方式 | 招贤纳士
声明:国际循环网( www.icirculation.com)对刊载的所有文章、视频、幻灯、音频等资源拥有全部版权。未经本站许可,不得转载。
京ICP备15014970号-5  互联网药品信息服务资格证书编号(京)-非经营性-2017-0063  京公网安备 11010502033353号  增值电信业务经营许可证:京ICP证150541号
国际循环 版权所有   © 2004-2024 www.icirculation.com All Rights Reserved
公司名称:北京美赞广告有限公司 公司地址:北京市朝阳区朝阳门北大街乙12号天辰大厦1座1409 电话:010-51295530