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ST resolution 1 hour after fibrinolysis for prediction of myocardial infarct size: insights from ASSENT 3
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2009 (English)In: The American journal of cardiology, ISSN 1879-1913, Vol. 103, no 2, 154-8 p.Article in journal (Refereed) Published
Abstract [en]

Acute ST-segment elevation myocardial infarction requires prompt restoration of myocardial perfusion to salvage myocardium at risk of ischemic necrosis and improve clinical outcome. Early resolution of ST-segment elevation during the time after reperfusion has been associated with both these end points. From the ASsessment of the Safety and Efficacy of a New Thrombolytic regimen (ASSENT) 3 trial, 3,425 patients were analyzed to investigate whether the amount of ST-segment resolution, divided into 3 groups (complete, >70%; partial, 30% to 70%; and no resolution, <30%), in the first hour after initiation of therapy was a predictor of final infarct size, estimated by peak creatine kinase and Selvester QRS score on the discharge electrocardiogram. Complete compared with partial and no ST resolution resulted in significantly (p<0.001) smaller infarct sizes of 10.5%, 13.2%, and 15.0% of the left ventricle and significantly (p=0.001) fewer patients with peak creatine >5 times the upper reference level at 50.3%, 71.8%, and 76.3%, respectively. In conclusion, our findings supported previous smaller studies suggesting that early resolution of ST elevation, as a sign of early myocardial reperfusion, resulted in less myocardial damage and preservation of left ventricular function.

Place, publisher, year, edition, pages
2009. Vol. 103, no 2, 154-8 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-103191DOI: 10.1016/j.amjcard.2008.08.054ISI: 000262564300002PubMedID: 19121428OAI: oai:DiVA.org:uu-103191DiVA: diva2:217698
Available from: 2009-05-15 Created: 2009-05-15 Last updated: 2010-05-03Bibliographically approved

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