ST-Segment Resolution as a Marker for Myocardial Scar in ST-Segment Elevation Myocardial Infarction

Abstract Objective: To investigate the relationship between ST-segment resolution (STR) and myocardial scar thickness after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).Methods: Forty-two STEMI patients with single-branch coronary artery stenosis or occlusion were enrolled. ST-segment elevations were measured at emergency admission and at 24 h after PCI. Late gadolinium-enhanced cardiac magnetic resonance imaging (CMR-LGE) was performed 7 days after PCI to evaluate myocardial scars. Statistical analyses were performed to assess the utility of STR to predict the development of transmural (>75%) or non-transmural (<75%) myocardial scars.Results: The sensitivity and specificity of STR for predicting transmural scars were 96% and 88%, respectively, at an STR cut-off value of 40.15%. The area under the curve was 0.92. Multivariate logistic proportional hazards regression analysis disclosed that patients with STR<40.15% had a 112.95-fold higher probability of developing transmural scars compared with patients with STR≥40.15%. STR percentage was negatively correlated with myocardial scar thickness (β=-0.838, P<0.001) and size (β=-0.714, P<0.001).Conclusion: STR<40.15% at 24 h after PCI may provide meaningful diagnostic nformation regarding the extent of myocardial scarification in STEMI patients.

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ST-segment resolution as a marker for severe myocardial fibrosis in ST-segment elevation myocardial infarction

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02269-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Qian Dong ◽

Xuesong Wen ◽

Guanglei Chang ◽

Rui Xia ◽

Sihang Wang ◽

...

Keyword(s):

Myocardial Infarction ◽

Proportional Hazards ◽

Pearson Correlation ◽

Area Under The Curve ◽

Emergency Admission ◽

Myocardial Scar ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Myocardial Scars

Abstract Objective To investigate the relationship between ST-segment resolution (STR) and myocardial scar thickness after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods Forty-two STEMI patients with single-branch coronary artery stenosis or occlusion were enrolled. ST-segment elevations were measured at emergency admission and at 24 h after PCI. Late gadolinium-enhanced cardiac magnetic resonance imaging (CMR-LGE) was performed 7 days after PCI to evaluate myocardial scars. Statistical analyses were performed to assess the utility of STR to predict the development of transmural (> 75%) or non-transmural (< 75%) myocardial scars, according to previous study. Results The sensitivity and specificity of STR for predicting transmural scars were 96% and 88%, respectively, at an STR cut-off value of 40.15%. The area under the curve was 0.925. Multivariate logistic proportional hazards regression analysis disclosed that patients with STR < 40.15% had a 170.90-fold higher probability of developing transmural scars compared with patients with STR ≥ 40.15%. Pearson correlation and linear regression analyses showed STR percentage was significantly associated with myocardial scar thickness and size. Conclusion STR < 40.15% at 24 h after PCI may provide meaningful diagnostic information regarding the extent of myocardial scarification in STEMI patients.

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ST-Segment Resolution As A Marker For Severe Myocardial Fibrosis in ST-Segment Elevation Myocardial Infarction

10.21203/rs.3.rs-562934/v1 ◽

2021 ◽

Author(s):

Qian Dong ◽

Xuesong Wen ◽

Guanglei Chang ◽

Rui Xia ◽

Sihang Wang ◽

...

Keyword(s):

Myocardial Infarction ◽

Proportional Hazards ◽

Area Under The Curve ◽

Emergency Admission ◽

Myocardial Scar ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Study Results ◽

Myocardial Scars

Abstract Objective To investigate the relationship between ST-segment resolution (STR) and myocardial scar thickness after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods Forty-two STEMI patients with single-branch coronary artery stenosis or occlusion were enrolled. ST-segment elevations were measured at emergency admission and at 24 h after PCI. Late gadolinium-enhanced cardiac magnetic resonance imaging (CMR-LGE) was performed 7 days after PCI to evaluate myocardial scars. Statistical analyses were performed to assess the utility of STR to predict the development of transmural (> 75%) or non-transmural (< 75%) myocardial scars, according to previous study. Results The sensitivity and specificity of STR for predicting transmural scars were 96% and 88%, respectively, at an STR cut-off value of 40.15%. The area under the curve was 0.92. Multivariate logistic proportional hazards regression analysis disclosed that patients with STR < 40.15% had a 112.95-fold higher probability of developing transmural scars compared with patients with STR ≥ 40.15%. STR percentage was negatively correlated with myocardial scar thickness (β=-0.838, P < 0.001) and size (β=-0.714, P < 0.001). Conclusion STR < 40.15% at 24 h after PCI may provide meaningful diagnostic information regarding the extent of myocardial scarification in STEMI patients.

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Serum Endocan Levels Predict Angiographic No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Coronary Intervention

Angiology ◽

10.1177/0003319720961954 ◽

2020 ◽

pp. 000331972096195

Author(s):

Mustafa Dogdus ◽

Mustafa Yenercag ◽

Mehmet Ozyasar ◽

Ahmet Yilmaz ◽

Levent Hurkan Can ◽

...

Keyword(s):

Myocardial Infarction ◽

Independent Predictor ◽

Area Under The Curve ◽

Coronary Intervention ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

No Reflow ◽

St Segment ◽

Percutaneous Coronary ◽

No Reflow Phenomenon

No-reflow phenomenon (NRP) is an important problem in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). Endocan is synthesized and secreted by activated vascular endothelium, and it has been shown to be related to endothelial dysfunction and inflammation. We aimed to evaluate the relationship between endocan levels and NRP. Consecutive patients (n = 137) with STEMI who had undergone coronary angiography and pPCI were enrolled into the study. The clinical characteristics of the patients were obtained and endocan levels were measured. Endocan levels were significantly higher in the NRP (+) group compared with the NRP (−) group ( P < .001). In multivariate analysis, endocan ( P < .001, OR = 2.39, 95% CI = 1.37-4.15) was found to be an independent predictor of NRP. An endocan value of >2.7 ng/mL has 89.6% sensitivity and 74.2% specificity for the prediction of the NRP (area under the curve: 0.832, P < .001). The present study demonstrated that the endocan level is an independent predictor of the NRP in patients with STEMI who underwent pPCI. Endocan levels may be helpful in detecting patients with a higher risk of insufficient myocardial perfusion and worse clinical outcome.

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