Author + information
- Received January 28, 1992
- Revision received June 22, 1992
- Accepted June 23, 1992
- Published online January 1, 1993.
- Makoto Kondo, MD∗,
- Kouji Tamura, MD,
- Hitoshi Tanio, MD and
- Yukio Shimono, MD
- ↵∗Address for correspondence: Makoto Kondo, MD, Division of Cardiology, Shimada Municipal Hospital, 1200-5 Noda Shimada, Shizuoka 427, Japan.
Objectives. The significance of ST segment re-elevation at reperfusion by thrombolysis was evaluated.
Background. The significance of ST re-elevation bas not been studied. Hence, we evaluated whether ST re-elevation is an indicator of marked myocardial necrosis after reperfusion.
Methods. Twelve-lead electrocardiograms were recorded serially, before thrombolysis and immediately after each coronary angiographic procedure during thrombolysis.
Results. In 32 patients with acute myocardial infarction, 15 showed transient ST re-elevation at reperfusion (group 1) and 17 showed reduction (group 2). Peak crcatine kinase (CK) and CK-MB isoenzyme activity levels were significantly higher in group 1 than in group 2. Twelve patients in group 1 had strongly positive findings on early technetium-99m pyropbosphate scintigraphy, compared with one patient in group 2 (p < 0.001). The regional ejection fraction did not increase from the acute phase to the chronic phase in group 1. The ST deviation before thrombolysis was significantly greater in group 1 than in group 2 (p < 0.001). All 14 patients in group 1 showed Thrombolysis in Myocardial Infarction (TIMI) grade 0 flow and 12 of these patients did not have good collateral flow before thrombolysis.
Conclusions. These data suggest that 1) ST re-elevation at reperfusion is a sign of limited myocardial salvage by thrombolysis, and 2) high ST elevation and TIMI grade 0 flow without good collateral flow before thrombolysis may be predictive variables for marked myocardial necrosis alter reperfusion.
- Received January 28, 1992.
- Revision received June 22, 1992.
- Accepted June 23, 1992.