Role of ST-Segment Resolution Alone and in Combination with Thrombolysis in Myocardial Infarction Flow in Patients Treated with Primary Percutaneous Coronary Intervention: 2-Year Results from the China Acute Myocardial Infarction Registry

• DOI: 10.2139/ssrn.4214526
• Publication Date: 2022-09-14T17:22:51Z
• Authors: Chao Wu; Jingang Yang; Ling Li; Weimin Li; Quanmin Jing; Haiyan Xu; Xuan Zhang; Yunqing Ye; Rui Fu; Qiuting Dong; Hui Sun; Xinxin Yan; Wenbo Zhang; Sidong Li; Yanyan Zhao; Yang Wang; Wei Li; Yongjian Wu; Fenghuan Hu; Chen Jin; Xiaojin Gao; Shubin Qiao; Yuejin Yang; China Acute Myoca...

Background: Reperfusion evaluation after primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) remains challenging in clinical practice. We aimed to evaluate the long-term prognostic significance of resolution (STR) alone and combination with Thrombolysis Myocardial Infarction (TIMI) flow PPCI STEMI. Methods: analyzed relationship between STR from one lead showing most prominent ST at 120 min 2-year all-cause mortality 5966 patients STEMI enrolled 108 hospitals participated China Acute registry January 2013 September 2014. The discordant TIMI value integrated analysis plus were also investigated.Findings: <50%, ≥50% complete occurred 1227 (20.6%), 3837 (64.3%) 902 (15.1%) respectively. Rates reduced by STR>50% (5.6%, hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.36-0.56; P<0.001) (5.1%, HR, 0.48; CI, 0.34-0.67; compared STR<50% (11.7%), results consistent across all subgroups. 1141 (20.8%). was lowest both successful (including STR≥50% STR) 3 (4.8%), intermediate when either these measures (mean, 8.5%), highest abnormal (29.4%). A significantly improved discrimination reclassification GRACE hospital discharge risk score predict mortality.Interpretation: Post-PPCI is a robust prognosticator yields complementary value, supporting two traditional indices as convenient reliable surrogate endpoint reperfusion practice.Funding: This work supported CAMS Innovation Fund Medical Sciences (CIFMS) (2020-I2M-C&T-B-050) Twelfth Five-Year Planning Project Scientific Technological Department (2011BAI11B02).Declaration Interest: authors declare no conflict interest.Ethical Approval: study approved Ethics Committee Fuwai Cardiovascular Hospital (No. 431). Written informed consent obtained eligible patients.