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Impact of resolution of ST-segment elevation after primary percutaneous coronary intervention on prognosis of STEMI patients
Weronika Oleśkowska-Florek, Magdalena Filip
Resolution of electrocardiographic ST-segment elevation (STR) after reperfusion therapy for acute myocardial infarction is a good marker of clinical outcome and prognosis of STEMI patients. The aim of the study was to analyze the resolution of maximal ST-elevation in relation to the left ventricular function.

Material and methods:
This study comprised 111 STEMI patients (pts) treated with primary percutaneous coronary intervention (pPCI) (77 men, aged 59.35 ± 10.98 years. ECG was performed before and 4 hours after pPCI. Medical history, clinical outcome, TIMI Risk Score, inflammatory reaction and echocardiographic examination (48 or 72 hours and 6 monts after intervention) were analyzed. According to changes of ST-elevation, patients were divided into 2 groups: group I (. 70% reduction in ST-segment elevation; n=20 pts) and group II (< 70% reduction in ST-
segment elevation; n=91 pts).

Baseline demographic characteristics were similar between the 2 groups except for a higher age in group II (p=0,0447). Patients from group I were more likely to have inferior MI while patients from group II – anterior and lateral MI (p<0.0001). ECG analysis revealed that patients with STR.70% (group I) had lower maximST-elevation on admission (p=0.0304). Higher CRP concentrations immediately after PCI were characteristic for
patients with STR<70% (group II) (p=0.0286). Left ventricular ejection fraction two days after STEMI and in 6-month observation was significantly higher in group I (p=0.0024 after pPCI and p=0.0314 6-months after pPCI). Patients with STR.70% (group I) had lower left ventricular end-systolic volume after intervention (p=0.0449), lower mean wall motion score index (p=0,0339) and lower TIMI Risk Score.

ST-segment analysis allows identification of patients at increased risk of venticular dysfunction after STEMI.
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