Clinical Outcomes of ST-segment Resolution following Primary Percutaneous Coronary Intervention: A Retrospective, Real-world Analysis from Qatar

Department

Internal Medicine

Document Type

Article

Publication Title

Heart Views

Abstract

Background: Resolution of ST elevation (STE) is the hallmark of successful thrombolysis for ST-elevation myocardial infarction (STEMI). However, the effect of persistent STE on in-hospital outcomes following primary percutaneous coronary intervention (PPCI) is not well established.

Methods: In this single-center retrospective cohort analysis, all patients admitted between January 1, 2016, and September 30, 2018, with a diagnosis of STEMI who underwent PPCI were included. Complete resolution was defined as a >70% decrease in the STE sum on the first electrocardiogram following PPCI. Partial resolution denoted a 30%-70% decrease, and persistent STE denoted a < 30% decrease or any increase in the STE sum. The study population was divided into two groups: (1) resolved STE incorporating complete and partial resolution and (2) persistent STE incorporating persistent and increased STE. Using multivariate logistic regression, we compared the rates of in-hospital mortality, cardiogenic shock, intensive care unit admission, clinical heart failure, and readmission for a cardiac reason and heart failure between the study groups.

Results: We included 1250 patients in the analysis. Most patients were male (96%) with a mean age of 52 ± 10 years. More than three-quarters were Asian. Compared with patients with resolved STE, patients with persistent STE had a higher risk of clinical heart failure (24% vs. 12%, adjusted odds ratio [aOR]: 1.7 [95% confidence interval (CI): 1.2-2.5], P = 0.003), cardiogenic shock (12.1% vs. 5.3%, aOR: 2.7 [95% CI: 1.73-4.24], P < 0.001), in-hospital mortality (5.1% vs. 2.1%, aOR: 4.8 [95% CI: 2.35-9.88], P < 0.001), and readmission for heart failure (6.9% vs. 1.6%, aOR: 3.9 [95% CI: 1.95-7.82], P < 0.001).

Conclusion: Persistent STE following PPCI is a quick clinical indicator of in-hospital adverse outcomes and readmission. Future studies may explore interventions, such as early intensive medical therapy, that can improve outcomes in this population.

First Page

157

Last Page

162

DOI

10.4103/heartviews.heartviews_89_25

Volume

26

Issue

3

Publication Date

7-1-2025

PubMed ID

41393814

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