Open AccessST Variability during the First 4 Hours of Acute Myocardial Infarction Predicts 1‐Year Mortality
Author(s) -
Johanson Per,
Swedberg Karl,
Dellborg Mikael
Publication year - 2001
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/j.1542-474x.2001.tb00108.x
Subject(s) - medicine , myocardial infarction , cardiology , fibrinolysis , st segment , placebo , st elevation , thrombolysis , reperfusion therapy , perfusion , alternative medicine , pathology
Background: Early and complete myocardial reperfusion is the goal when treating a patient with acute myocardial infarction. To achieve this in each individual, an on‐line, accurate, easily handled and preferably noninvasive technique to monitor flow alterations is needed. Recurrent ST‐segment elevation has been shown to reflect cyclic disturbances in perfusion. Methods: We have retrospectively analyzed ST variability in 102 patients with acute myocardial infarction randomized to 100 mg of rt‐Pa or placebo. Patients were monitored for 24 hours using vectorcardiography. Results: Patients alive at one year (86%) had significantly less ST variability during the first four hours: 4.3 versus 7.1 episodes, P = 0.007. Patients having six or more ST episodes showed a 31.3% one‐year mortality as compared to no mortality in patients having no ST variability. Furthermore ST variability was reduced by fibrinolysis. Conclusion: Early ST variability detectable in real time is associated with worse outcome. A.N.E. 2001; 6(3):198–202