Prognostic effects of ST-segment resolution after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction in Erbil.

Abstract

Background: Although ST-segment resolution (STR) after primary percutaneous coronary intervention
(PPCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) was considered a useful
marker for assessing reperfusion efficiency, its prognostic effect remains a topic of controversy.
Objectives: The main purpose of this study was to evaluate the prognostic effects of STR after PPCI in
patients with acute STEMI.
Patients and Methods: In this cohort study, STR was assessed 30 minutes after PPCI in 300 patients with
acute STEMI. Patients were divided into two groups according to the degree of STR; group I, 225 patients
with complete STR (≥ 50%), and group II, 75 patients with incomplete STR (< 50%). Both groups were
assessed and compared regarding baseline, angiographic and outcomes up to two years of follow-up.
Results: Group II patients were more hypertensive, diabetic, hypercholesterolemic, and with a high
incidence of prior myocardial infarction. Besides, they had a high prevalence of Killip II and III classes, a
high percentage of anterior and double wall infarctions, more heart rate, less hemoglobin level, high blood
urea creatinine, and troponin levels. Moreover, left ventricular ejection fraction during follow-up was
significantly lower in them. In addition, the mean sum of ST-segment elevation was higher in group II
compared to group I. Patients of group I had a shorter door-to-balloon time , a higher rates of postinterventional TIMI flow grade 3. Group II patients had more non-fatal MI events, and a higher death rate
in the end of the study.
Conclusion: ST-segment resolution accomplished early after PPCI is an easy, effective and inexpensive
method for predicting the outcomes in patients with acute STEMI.