Abstract
Background In patients with acute myocardial infarction (AMI), the relationship of serial changes in ST-segment elevation after reperfusion to left ventricular (LV) function remains unclear. Methods and Results The study group comprised 164 patients with reperfused anterior AMI within 6 h of symptom onset. The sum of ST-segment deviation was calculated on admission (ΣST-admission), and 1 h (ΣST-1 h) and 24 h (ΣST-24 h) after reperfusion. ST resolution was defined as a reduction in ΣST-1 h of ≥50% as compared with ΣST-admission. Patients were classified into 3 groups: group A, 82 patients with ST resolution in whom ΣST-1 h ≥ ΣST-24 h; group B, 37 patients with ST resolution in whom ΣST-1 h < ΣST-24 h; group C, 45 patients without ST resolution. Peak creatine kinase were higher in groups B and C than in group A (4,578±2,176, 4,236±2,638, 2,222±1,926 mU/ml, p<0.01). At 6 months follow-up, the LV ejection fraction were lower in groups B and C than in group A (53±8, 54±12, 62±9%, p<0.01). Conclusions An increase in ST-segment elevation 1-24 h after reperfusion, despite ST resolution, is associated with a larger infarction and poorer LV function in patients with reperfused anterior AMI. (Circ J 2008; 72: 409 - 414)
