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ST resolution 1 hour after fibrinolysis for prediction of myocardial infarct size: insights from ASSENT 3

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  • Per Johanson, Denmark
  • Yuling Fu, Denmark
  • Galen S Wagner, Denmark
  • Shaun G Goodman, Denmark
  • Chris B Granger, Denmark
  • Lars Wallentin, Denmark
  • Frans Van de Werf, Denmark
  • Paul W Armstrong, Denmark
  • ASSENT 3 Investigators
  • The Department of Internal Medicine and Cardiology A
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.
Original languageEnglish
JournalAmerican Journal of Cardiology
Volume103
Issue2
Pages (from-to)154-8
Number of pages4
ISSN0002-9149
DOIs
Publication statusPublished - 2008

    Research areas

  • Aged, Biological Markers, Creatine Kinase, Electrocardiography, Female, Fibrinolytic Agents, Humans, Logistic Models, Male, Middle Aged, Myocardial Infarction, Risk Factors, Thrombolytic Therapy, Treatment Outcome

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