ST resolution after mechanical reperfusion closely correlates with myocardial salvage and associtated with patients prognosis after acute anteroseptal MI

Abstract

Background: Early resolution of ST-segment elevation is an indicator of final infarct size and clinical outcomes. However, the relationship between the degree of ST resolution and the indexes derived from perfusion scintigraphy such as area at risk(AAR), infarct size(IR), and salvaged myocardium(SI) is unclear. Methods: Consecutive 65 patients with anteroseptal myocardial infarction with successful mechanical reperfusion, whose AAR, IS, and SI could be assessed by myocardial perfusion imaging, were studied. Serial 12 leads electrocardiograms were performed at baseline, 90 minutes after reperfusion. ST resolution was defined as complete (>70%, n = 16), partial (<70% to 30%, n = 36), or no resolution (<30%, n = 13). Results: Patients with no resolution group tended to be longer time to reperfusion (complete: 4.0 ± 7.5 partial: 6.5 ± 8.2 No: 7.4 ± 6.6). Peak CPK inversely correlated with level of ST resolution(complete:1689 ± 1395 partial:3078 ± 2577 No:5252 ± 2537 p < 0.01). As for the scintigraphical indexes such as AAR, IR, and SI, all these indexes had significant association with the level of ST resolution(AAR: complete 114 ± 54 partial 145 ± 58 no 178 ± 51 p < 0.05, IS:complete 21 ± 26 partial 66 ± 60 no 131 ± 31 p < 0.001, SI: complete 81.9 ± 16.2 partial 57.6 ± 29.4 no 27.7 ± 23.9 p < 0.001). Furthermore, patients with no resolutions experienced high prevalence of the occurrence of congestive heart failure than partial and complete resolution groups. Conclusion: Early resolution of ST-segment elevation closely correlated with AAR, IS, and SI as assessed by scintigraphy and closely associated with patients prognosis.