Noninvasive detection of coronary artery patency using continuous ST-segment monitoring.
Continuous ST-segment Holter recordings were analyzed from 46 patients with acute myocardial infarction (AMI) receiving intracoronary streptokinase (SK) during the first 48 hours of hospitalization. Changes in ST deviation and the time periods of these changes were quantitated and correlated with angiographic evidence of reperfusion. Thirty-six patients had total occlusion of the infarct vessel and 10 had subtotal occlusion. Of the 36 vessels that were totally occluded, 19 were reperfused and 17 were not. In patients in whom reperfusion was successful, an ST steady state was achieved 55 +/- 32 minutes after SK administration. In patients in whom it was not successful, a steady state was achieved in 219 +/- 141 minutes (p less than 0.001). Achievement of steady state within 100 minutes after SK reperfusion indicated successful reperfusion with 89% sensitivity and 82% specificity. All patients with subtotal occlusion achieved an ST steady state before SK infusion. No patient with total occlusion achieved a steady state before SK. Achievement of ST steady state before SK infusion was 100% sensitive and 100% specific for subtotal occlusion at initial angiography. Continuous, quantitative ST-segment analysis is a sensitive and specific noninvasive technique for following coronary artery patency during AMI.
Duke Scholars
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Related Subject Headings
- Time Factors
- Streptokinase
- Perfusion
- Myocardial Infarction
- Monitoring, Physiologic
- Humans
- Coronary Vessels
- Cardiovascular System & Hematology
- 3201 Cardiovascular medicine and haematology
- 1102 Cardiorespiratory Medicine and Haematology
Citation
Published In
DOI
ISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Time Factors
- Streptokinase
- Perfusion
- Myocardial Infarction
- Monitoring, Physiologic
- Humans
- Coronary Vessels
- Cardiovascular System & Hematology
- 3201 Cardiovascular medicine and haematology
- 1102 Cardiorespiratory Medicine and Haematology