IJCRR - 6(9), May, 2014
ST-SEGMENT RESOLUTION: A CRITERION OF SUCCESSFUL THROMBOLYSIS IN ACUTE MYOCARDIAL INFARCTION
Author: Nilay Suthar, Paltial Palat, Shivkumar Masaraddi, Manish Patel, Dilip Modi
Background: Thrombosis of the coronary artery is the principal cause of myocardial infarction in the territory of the affected vessel. To limit the size of infract area and for the salvage of the jeopardized myocardium, restoration of patency of infarct related coronary artery is very important to reduce morbidity and mortality in these patients.1,2 The physician's ability to predict patency of the infarct related artery from clinical variables however is disappointing. The role of ST-segment resolution during an ST segment infarction has over the years, grown into not only an alternative way of approximating risk and chances of reperfusion in the absence of a coronary angiogram, but also a method challenging the traditional "gold standard" for predicting risk and reperfusion at the myocardial level. Thus, ST-segment resolution at 90 minutes is an excellent marker of successful myocardial reperfusion1 and a strong predictor of survival and preservation of left ventricular function.3-5 Aims and Objectives: We studied the relation between ST-segment resolution and various outcomes in cases of acute myocardial infarction at our institute.Our aim was to study ST-segment resolution as a marker and a simple bedside tool for predicting of successful myocardial reperfusion, 90 minutes after thrombolysis in STEMI (ST elevation myocardial infarction).We also studied and attempted to correlate ST-segment resolution at 90 minutes after thrombolysis as a predictor of recovery, in-hospital adverse events, morbidity and mortality in STEMI. Methods: The present study was conducted on 50 patients who had received thrombolytic therapy with streptokinase for ST Elevation AMI, in our ICCU. Detailed clinical history with specific emphasis on presenting complaint and associated coronary risk factors and management done were captured. Results: The study corroborates the evidence that the recanalization and the patency of the IRA (Infarct Related Artery) remained higher in the patients with complete resolution of ST-segment at 90 minutes group, than the patients with partial resolution and the no resolution groups. Conclusions: ST-segment resolution can be used as a simple non-invasive tool for the prediction of the patency of the IRA after thrombolysis.
Keywords: St-segment, resolution, Acute Myocardial Infarction, thrombolysis.
Nilay Suthar, Paltial Palat, Shivkumar Masaraddi, Manish Patel, Dilip Modi. ST-SEGMENT RESOLUTION: A CRITERION OF SUCCESSFUL THROMBOLYSIS IN ACUTE MYOCARDIAL INFARCTION International Journal of Current Research and Review. 6(9), May, 99-108
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