Predictors and clinical implications of minimal ST-segment elevation in patients with ST-segment elevation myocardial infarction

Cardiology. 2014;128(3):273-81. doi: 10.1159/000362438. Epub 2014 May 28.

Abstract

Objectives: Some patients with suspected ST-segment elevation (STE) myocardial infarction (STEMI) show STE that does not fulfill the current criteria for STEMI. The purpose of this study was to investigate the characteristics and prognoses of patients with minimal STEMI.

Methods: Between November 2007 and December 2011, 546 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI were enrolled.

Results: The minimal STE group had a higher proportion of women (30.2 vs. 21.0%, p = 0.031), better pre-PCI antegrade flow (Thrombolysis in Myocardial Infarction flow 2-3, 30.2 vs. 18.8%, p = 0.006) and better collateralization (Rentrop score 2-3, 27.4 vs. 18.1%, p = 0.024) compared to the definite STE group. Multivariate analysis showed that each of them were independent predictors for minimal STE. However, 1-year mortality of the minimal STE group did not differ from that of the definite STE group (7.1 vs. 9.3%, log-rank p = 0.315).

Conclusions: Female gender, good collateral flow and good pre-PCI antegrade flow were independent predictors for minimal STE in patients with STEMI. However, minimal STE was not related to a good prognosis in patients with STEMI.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Blood Pressure / physiology
  • Collateral Circulation / physiology
  • Coronary Angiography
  • Coronary Circulation / physiology
  • Electrocardiography
  • Female
  • Heart Rate / physiology
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / surgery
  • Percutaneous Coronary Intervention*
  • Prognosis
  • Retrospective Studies
  • Sex Factors
  • Time-to-Treatment