Factors associated with incomplete ST-segment resolution after coronary intervention in patients with ST-segment elevation myocardial infarction in Erbil city, Iraq.

Abstract

Background: The factors associated with incomplete ST-segment resolution (STR) after primary
percutaneous coronary intervention (PPCI) in patients with acute ST-segment elevation myocardial
infarction (STEMI) were still not clear.
Aim: The main aim of the current study was to identify the factors associated with incomplete STR after
PPCI in a group of patients with acute STEMI in Erbil city, Iraq.
Patients and Methods: In this cross-sectional study, STR was performed 30 minutes after PPCI in 120
patients with acute STEMI. Patients were divided into two groups according to the degree of STR; group I,
86 patients with complete STR (≥ 50%), and group II, 34 patients with incomplete STR (< 50%). Both
groups were evaluated and compared regarding baseline clinical and angiographic characteristics by
univariate and multivariate analysis.
Results: Group II patients were more diabetic and hypercholesterolemic, with a high incidence of prior
myocardial infarction. Besides, they had a high prevalence of Killip II and III classes, more anterior and
lateral wall infarctions, higher heart rate, with high blood urea, creatinine, troponin, and CK-MB levels.
Moreover, they had a lower left ventricular ejection fraction (LVEF). In addition, they had a higher
incidence of the occluded left main and left anterior descending arteries, more number of occluded
coronary arteries, a higher rate of pre-intervention TIMI flow grade 0, and a lesser rate of postinterventional TIMI flow grade 3.
Conclusion: Several factors were associated with incomplete STR .TIMI flow grade, number of diseased
arteries, blood urea, and serum creatinine were associated with the highest probability of incomplete STR.
Diabetes mellitus, previous MI, Killip class, heart rate, LVEF, culprit coronary artery, troponin and CKMB levels were also significantly associated with incomplete STR.