2018, Number 3
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Rev Mex Cardiol 2018; 29 (3)
Early T-wave inversion in anterior leads predict patency of the anterior descending artery in ST-segment elevation myocardial infarction
Barrera-Oranday EA, Cortés de la Torre JM, Rodríguez CJM, Arias-Mendoza A
Language: English
References: 17
Page: 120-125
PDF size: 262.41 Kb.
ABSTRACT
Introduction: T-wave inversion has always been considered as a natural progression sign of the non-perfunded myocardial infarction, however it is also seen after early succesful reperfusion via fibrinolysis or primary angioplasty; its role in predicting auto-reperfusion has not been established.
Objective: Assess the patency of the infarct-related artery (IRA) in patients presenting with early (‹ 3 hours of symptoms onset) T-wave inversion (TWI) in leads with ST-segment elevation (STE) myocardial infarction (STEMI).
Methods: We retrospectively analyzed 432 patients admitted at the emergency department of the National Cardiology Institute in Mexico City with a diagnosis of STEMI who arrived within three hours of symptoms onset and underwent primary percutaneous coronary intervention (p-PCI) from October 2005 to November 2015. Clinical data, electrocardiogram (ECG) and angiographic data were reviewed. The subjects were divided in two groups: those with TWI and those with positive T waves (PTW).
Results: 386 (89.3%) patients presented with PTW and 46 (10.6%) with TWI. The presence of early TWI in anterior leads predicted patency of the anterior descending artery (LAD) (18 [69.2%] vs 41 [24%]; p ‹ 0.001) but not in other arteries.
Conclusions: The presence of early TWI in anterior leads with STE is associated with patency of the LAD. This relationship was not found in other infarct-related arteries.
REFERENCES
American College of Emergency Physicians; Society for Cardiovascular Angiography and Interventions, O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013; 61 (4): e78-e140.
Nable JV, Brady W. The evolution of electrocardiographic changes in ST-segment elevation myocardial infarction. Am J Emerg Med. 2009; 27 (6): 734-746.
Matetzky S, Barabash GI, Shahar A, Rabinowitz B, Rath S, Zahav YH et al. Early T wave inversion after thrombolytic therapy predicts better coronary perfusion: clinical and angiographic study. J Am Coll Cardiol. 1994; 24 (2): 378-383.
Corbalán R, Prieto JC, Chavez E, Nazzal C, Cumsille F, Krucoff M. Bedside markers of coronary artery patency and short-term prognosis of patients with acute myocardial infarction and thrombolysis. Am Heart J. 1999; 138 (3 Pt 1): 533-539.
Doevendans PA, Gorgels AP, van der Zee R, Partouns J, Bär FW, Wellens HJ. Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in acute myocardial infarction. Am J Cardiol. 1995; 75 (17): 1206-1210.
Alsaab A, Hira RS, Alam M, Elayda M, Wilson JM, Birnbaum Y. Usefulness of T wave inversion in leads with ST elevation on the presenting electrocardiogram to predict spontaneous reperfusion in patients with anterior ST elevation acute myocardial infarction. Am J Cardiol. 2014; 113 (2): 270-274.
Hira RS, Moore C, Huang HD, Wilson JM, Birnbaum Y. T wave inversions in leads with ST elevations in patients with acute anterior ST elevation myocardial infarction is associated with patency of the infarct related artery. J Electrocardiol. 2014; 47 (4): 472-477.
Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012; 33 (20): 2569-2619.
Eskola MJ, Holmvang L, Nikus KC, Sclarovsky S, Tilsted HH, Huhtala H et al. The electrocardiographic window of opportunity to treat vs. the different evolving stages of ST-elevation myocardial infarction: correlation with therapeutic approach, coronary anatomy, and outcome in the DANAMI-2 trial. Eur Heart J. 2007; 28 (24): 2985-2991.
Wehrens XH, Doevendans PA, Ophuis TJ, Wellens HJ. A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty. Am Heart J. 2000; 139 (3): 430-436.
Stone GW, Cox D, Garcia E, Brodie BR, Morice MC, Griffin J et al. Normal flow (TIMI-3) before mechanical reperfusion therapy is an independent determinant of survival in acute myocardial infarction: analysis from the primary angioplasty in myocardial infarction trials. Circulation. 2001; 104 (6): 636-641.
Ernst N, Zijlstra F, de Boer MJ, Dambrink JH, Gosselink AT, Henriques JP et al. The importance of patency of the infarct-related artery in treatment of patients with acute myocardial infarction. Neth Heart J. 2003; 11 (1): 11-14.
Messner B, Bernhard D. Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis. Arterioscler Thromb Vasc Biol. 2014; 34 (3): 509-515.
Sahin DY, Gür M, Elbasan Z, Yıldız A, Kaya Z, Içen YK et al. Predictors of preinterventional patency of infarct-related artery in patients with ST-segment elevation myocardial infarction: Importance of neutrophil to lymphocyte ratio and uric acid level. Exp Clin Cardiol. 2013; 18 (2): e77-e81.
Acet H, Ertaş F, Akıl MA, Özyurtlu F, Yıldız A, Polat N et al. Novel predictors of infarct-related artery patency for ST-segment elevation myocardial infarction: Platelet-to-lymphocyte ratio, uric acid, and neutrophil-to-lymphocyte ratio. Anatol J Cardiol. 2015; 15 (8): 648-656.
Kilickesmez KO, Bingöl G, Bulut L, Sinan UY, Abaci O, Ersanli M et al. Relationship between serum endothelin-1 level and spontaneous reperfusion in patients with acute myocardial infarction. Coron Artery Dis. 2015; 26 (1): 37-41.
Börekçi A, Gür M, Türkoğlu C, Selek Ş, Baykan AO, Şeker T et al. Oxidative stress and spontaneous reperfusion of infarct-related artery in patients with ST-segment elevation myocardial infarction. Clin Appl Thromb Hemost. 2016; 22 (2): 171-177.