Resolution of ST depression after fibrinolysis can be more important than resolution of ST elevation for many patients with inferior STEMIs

Wong, Cheuk‐Kit; Gao, Wanzhen; White, Harvey D.

doi:10.1016/j.ijcard.2014.12.117

Cited by 9 publications

(10 citation statements)

References 11 publications

(9 reference statements)

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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: 91%

“…20 Nevertheless, for subjects with inferior STEMI, recent studies showed that resolution in reciprocal STSD is far more important than the elevation in ST segment itself as short-term prognostic marker. 21 Considering the importance of resolution in reciprocal STSD as a simple parameter, but efficient, for predicting prognosis in patients with STEMI receiving early reperfusion, the author wants to compare the MACEs outcome between those with and without resolution in reciprocal STSD.…”

Section: Introductionmentioning

confidence: 99%

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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: 91%

Section: Introductionmentioning

confidence: 99%

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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“…Importantly, resolution of lateral ST depression was an independent predictor of lower 30-day mortality [7]. This corroborated our earlier findings that resolution of aVR ST elevation was associated with lower 30-day mortality [4].…”

Section: Accepted Manuscriptsupporting

confidence: 89%

Reply to letter by Kirat and Kӧse: Maximizing information from a 12-lead electrocardiogram

Wong

White

2015

International Journal of Cardiology

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“…Recently, a subanalysis of the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial showed that STD-R after PCI provides strong independent prognostic information that is incremental to STR 6. In line with these data, Wong et al 7 found that in patients with inferior STEMI treated with fibrinolysis STD-R is prognostically more important than standard STR. However, the underlying mechanism for the strong association between STD-R and adverse outcome remains poorly understood and most prognostic data are only available for relatively short follow-up periods.…”

Section: Introductionmentioning

confidence: 95%

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

Reinstadler

Baum

Rommel

et al. 2015

Heart

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Resolution of ST depression after fibrinolysis can be more important than resolution of ST elevation for many patients with inferior STEMIs

Cited by 9 publications

References 11 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

Reply to letter by Kirat and Kӧse: Maximizing information from a 12-lead electrocardiogram

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

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