Resolução do segmento ST após intervenção coronária percutânea primária: características, preditores de insucesso e impacto na mortalidade

Abstract

Background: ST-segment resolution is an important predictor of infarct-related artery patency and effective microcirculatory perfusion. The aim of this study was to compare patients with and without ST-segment elevation resolution and identify variables that are associated with failure of ST-segment resolution. Methods: Between March 2012 and July 2013, 61 patients with ST-segment elevation acute myocardial infarction underwent primary percutaneous coronary intervention (PCI) and were included in a prospective registry. To compare the groups with and without ST-segment resolution, the chi-square test or Fisher's exact test were used for qualitative variables and Student's t test or Mann-Whitney's test for quantitative variables. Simple and multiple logistic regression models were used to identify variables associated with failure of ST-segment resolution. Results: The group of patients without ST-segment resolution had higher heart rate, higher prevalence of diabetes mellitus, chronic renal failure and a trend towards longer ischemia time. There was a higher mortality rate in patients who did not achieve ST-segment elevation resolution. In the univariate analysis, heart rate, diabetes mellitus, chronic renal failure and ischemia time were associated with increased odds of not obtaining ST-segment resolution, losing significance in the multivariate model. Conclusions: Failure of ST-segment resolution is observed in up to one-third of patients undergo-1 Postgraduate student (Doctoral). Interventionist Cardiologist Physician at Santa

Results of Primary Percutaneous Coronary Intervention According to the Total Ischemic Time

“…12 In an electrocardiographic subanalysis of the PLATelet Inhibition and Patient Outcomes (PLATO) trial, 70% of patients randomized in the range 3 to 6 hours of symptom onset exhibited ST-segment resolution, compared to 51% of those randomized after 6 hours. 13 A similar result was found by Andrade et al, 14 who demonstrated the association of longer ischemic time with incomplete resolution of ST-segment elevation. The survival benefits and other relevant outcomes, associated with a lower symptom onset-to-balloon time, can be observed even in long-term evolution.…”

Além da recanalização do vaso culpado no infarto com supradesnivelamento do segmento ST

“…In this issue, Andrade et al 13 evaluated 61 patients who underwent primary PCI between March 2012 and July 2013, comparing their clinical and angiographic characteristics in relation to the resolution of the STsegment, which occurred in one third of cases. The group of patients without ST-segment resolution showed higher heart rate, prevalence of diabetes mellitus, and chronic renal failure, and a tendency to longer ischemic time; mortality was also higher in these patients.…”