Karamasis GV, et al. - This study aimed to determine the presence and clinical results of intra-procedural ST segment resolution (STR) during primary percutaneous coronary intervention (PPCI). In less than half of the total cases, good peri-procedural ST resolution was observed, which carried crucial clinical consequences. Overall, detection of suboptimal peri-procedural ST resolution could help identify patients who may benefit from new treatments aimed at protecting microcirculation, whilst the patients are still in the angiography laboratory.

Methods

• An analysis was performed of 12 lead ECGs recorded at the onset and the end of the PPCI procedure, measuring STR in the lead with maximum ST elevation on the initial recording.
• STR was defined as good when > 50% compared to baseline.

Results

• Data reported that pre and immediately post PPCI ECGs were recorded in 467 STEMI cases whilst the patient was on the catheter lab table.
• It was also noted that mean patient age was 63 (+/- 12) years old and 75% were men.
• 3.8 (+/- 3.4) hours was the mean duration of symptoms to admission and 51% of infarcts were anterior.
• Researchers observed good ST resolution at the end of the procedure in 46.5% of patients and it this finding was common in inferior versus anterior infarcts (60.1% vs. 32.6%, p<0.001), and in current smokers (53.2% vs. 42.4%, p=0.031).
• They also found that good STR was more common in patients presenting with symptoms for < 4 hours (74% vs. 66%, p=0.019).
• Findings demonstrated a more frequent use of thrombus aspiration in patients who had good STR (88.5% vs 79.8% p=0.011).
• In addition, data reported a shorter mean hospital length of stay (3.8 vs. 4.5 days, p=0.009) and a higher left ventricular ejection fraction (49.9% vs. 44.2%, p<0.001) in patients with good ST resolution, as measured by transthoracic echocardiography prior to discharge.