Combined Assessments of Biochemical Markers and ST-Segment Resolution Provide Additional Prognostic Information for Patients With ST-Segment Elevation Myocardial Infarction.

Content Provider	Europe PMC
Author	Woo, Jong Shin Cho, Jin Man Kim, Soo Joong Kim, Myeong Kon Kim, Chong Jin
Copyright Year	2011
Abstract	Background and ObjectivesThe prognostic value of biochemical markers and the resolution of ST-segment elevation on electrocardiogram are well established. However, how a combination of these two tools affects the evaluation of risk stratification has not yet been evaluated.Subjects and MethodsBetween January 2006 and June 2008, 178 consecutive patients treated with primary percutaneous coronary interventions after ST-segment elevation myocardial infarctions (STEMI) were analyzed at two coronary care units. Patients were divided into the following three groups according to ST-segment resolution: complete (≥70% depression of the elevated ST-segment, n=63), partial (30% to 70%, n=90), and incomplete (<30%, n=25). Demographic data, including history, electrocardiography, biochemical markers, initial ejection fraction, and angiographic findings were also evaluated.ResultsThere were 7 deaths, 3 repeated myocardial infarctions, and 17 readmissions for worsening heart failure during six months of follow-up. In a multivariate analysis to predict clinical outcomes, ejection fraction {hazard ratio (HR): 0.83 (0.76-0.91), p<0.01}, high-sensitivity C-reactive protein {HR: 1.15 (1.05-1.26), p<0.05}, and the degree of ST-segment resolution {HR: 0.96 (0.93-0.09), p<0.05} were independently associated with clinical outcomes. According to the Cox-proportional hazards model, the addition of ST-segment resolution markedly improved the prognostic utility of the model containing biochemical markers and ejection fraction.ConclusionAssessment of biomarkers upon admission and ST-segment resolution are strong predictors of clinical outcomes. The combination of these data provides additive information about prognosis at an early point in the disease progression and further improves risk stratification for STEMI.
ISSN	17385520
Journal	Korean Circulation Journal
Volume Number	41
PubMed Central reference number	PMC3152731
Issue Number	7
PubMed reference number	21860638
e-ISSN	17385555
DOI	10.4070/kcj.2011.41.7.372
Language	English
Publisher	The Korean Society of Cardiology
Publisher Date	2011-07-30
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2011 The Korean Society of Cardiology
Subject Keyword	Myocardial infarction Prognosis C-reactive protein N-terminal pro-B-type natriuretic peptide Electrocardiogram
Content Type	Text
Resource Type	Article
Subject	Internal Medicine Cardiology and Cardiovascular Medicine