Author + information
- Wichert Jan Kuijt,
- Niels Verouden,
- Peter Damman,
- Joost Haeck,
- Karel T. Koch,
- Jan Tijssen and
- Robbert de Winter
ST-segment elevation myocardial infarction (STEMI) remains responsible for considerable morbidity and mortality. Quickly dentifying high-risk patients can aid in choosing appropriate adjuvant therapy. The recovery of the ST-segment has consistently shown strong prognostic value. However, quantitave measures can be cumbersome in practice. We investigated whether qualitative assessment of the ST-segment by the Sclarovsky-Birnbaum pre-procedural ischemia grade (PRE-IG) and/or post-procedural ischemia grade (POST-IG) is significantly associated with long-term clinical outcome and thus can serve as an easy tool for early risk stratification.
12-lead ECGs from 274 STEMI patients, who underwent primary PCI at the Academic Medical Centre University of Amsterdam between January 1, 2005, and December 31, 2005, were analyzed. Pre-and post procedural ECGs were graded on ischemia using the Sclarovsky-Birnbaum criteria. Univariable 1-year mortality was compared using the Kaplain-Meier method with Log-rank test. Multivariable analysis correcting for TIMI riskfactors (age, cardiogenic shock, anterior location of the infarct, weihgt, hypertension, diabetes, time to treatment, systolic and diastolic bloodpressure, anterior location) was performed using Cox-proportional hazard models.
Unadjusted 1-Year mortality of PRE-IG 0, 1, 2 and 3 was 0, 0, 7 and 14 percent respectively (p = 0.043). 1-Year mortality in grade 0, 1, 2 and 3 of POST IG was 1, 5, 9 and 26 percent respectively (p < 0.001). After adjusting for known risk factors, pre- and post-procedural ischemia grading still showed significant association with all-cause 1-year mortality (P< 0.05). After adjustment for eacht other, post-IG remained a significant predictor of 1-year mortality (p<0.001).
Post-procedural ischemia grading was independently associated with long-term mortality and can potentially serve as a tool for early risk stratification.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Percutaneous Coronary Intervention for AMI: Predictors of Outcome
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1216-213
- 2013 American College of Cardiology Foundation