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Postprocedural single-lead ST-segment deviation and long-term mortality in patients with ST-segment elevation myocardial infarction treated by primary angioplasty
  1. Giuseppe De Luca (p.de_luca{at}libero.it)
  1. Ospedale "Maggiore della Carita", Novara, Italy
    1. Harry Suryapranata
    1. Hospital De Weezenlanden, Zwolle, Netherlands
      1. Jan Paul Ottervanger
      1. Hospital De Weezenlanden, Zwolle, Netherlands
        1. Jan C A Hoorntje
        1. Hospital De Weezenlanden, Zwolle, Netherlands
          1. A T Marcel Gosselink
          1. Hospital De Weezenlanden, Zwolle, Netherlands
            1. Jan-Henk Dambrink
            1. Hospital De Weezenlanden, Zwolle, Netherlands
              1. Menko-Jan de Boer
              1. Hospital De Weezenlanden, Zwolle, Netherlands
                1. Arnoud W J van't Hof (hof{at}isala.nl)
                1. Hospital De Weezenlanden, Zwolle, Netherlands

                  Abstract

                  Objective To evaluate the prognostic role of postprocedural single-lead residual ST-segment deviation for electrocardiographic evaluation of myocardial perfusion in patients with STEMI treated by primary angioplasty.

                  Design Prospective observational clinical cohort study.

                  Setting Tertiary referral center.

                  Patients Our population is represented by a total of 1660 patients treated with primary angioplasty for STEMI.

                  Main outcome measure Mortality at 1-year follow-up.

                  Results Single-lead ST-segment deviation significantly correlated with infarct size, predischarge ejection fraction, distal embolization and myocardial blush grade (MBG) 3. At 1-year follow-up, a total of 63 patients had died. The method well correlated with 1-year mortality. At multivariate analysis, after correction for baseline demographic, clinical and angiographic variables, postprocedural single-lead ST-segment deviation showed the best accuracy as compared to single-lead ST-segment elevation or resolution and residual 12-lead ST-segment deviation.

                  Conclusions This study showed that maximal residual ST-segment deviation in a single lead at 3 hours after the procedure is an easy and accurate predictor of 1-year mortality after primary angioplasty for STEMI.

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