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Association between ST segment Resolution following Fibrinolytic therapy or Intracoronary stenting, and Reinfarction in the same myocardial region in the DANAMI-2 study population.

Publication ,  Journal Article
Dawkins, K; Busk, M; Sorensen, J; Mortensen, LS; Maynard, C; Stinnett, SS; Wagner, GS; Andersen, HR; DANAMI-2 investigators
Published in: Cardiovasc Revasc Med
2011

BACKGROUND: ST-segment resolution has long been used as one of several clinical markers of response to reperfusion therapy. With the use of the DANish trial in Acute Myocardial Infarction-2 (DANAMI-2) database, this case-control study tests the hypothesis that incomplete ST-segment resolution (<70%) will be predictive of the risk of reinfarction in the same myocardial region regardless of the reperfusion therapy employed. METHODS AND RESULTS: One hundred forty-nine (9.5%) patients with clinical reinfarction were matched to patients with no documented reinfarction ("no reinfarction"). With the use of the initial DANAMI-2 and reinfarction electrocardiograms, 80 patients were found to have reinfarction in the same myocardial region ("reinfarction"). "Reinfarction" and their matched "no-reinfarction" patients were included (n=160), and prereperfusion and postreperfusion ST segments were measured manually. Of all "reinfarction" patients, 66% (53 of 80) had incomplete ST-segment resolution [P=.13; odds ratio (OR)=1.69]. Stratified by the reperfusion strategy employed, this corresponded to 67% (35 of 52) being treated with fibrinolytics (P=.45; OR=1.33), suggesting that these patients were equally likely to reinfarct in the same myocardial region regardless of the degree of ST-segment resolution. In the primary percutaneous coronary intervention (pPCI) arm, 64% (18 of 28) of patients with reinfarction in the same myocardial region had incomplete ST-segment resolution (P=.10; OR=6.0). In the pPCI arm, the trend was that patients with incomplete ST-segment resolution were more likely to reinfarct in the same myocardial region than those with complete ST-segment resolution, but these findings did not reach statistical significance. No statistically significant difference was found in the association of reinfarction in the same myocardial region and ST-segment resolution between the two treatment arms (P=.11). CONCLUSION: The results from this study suggest that, although fibrinolytic-treated patients are more likely to reinfarct in the same myocardial region than pPCI-treated patients, there is no clear statistically significant association between ST-segment resolution and reinfarction in the same myocardial region. Trends in the data suggest that fibrinolytic-treated patients are equally likely to reinfarct in the same myocardial region regardless of the degree of ST-segment resolution. However, the trend in the pPCI population is such that incomplete ST-segment resolution is associated with a higher likelihood of reinfarction in the same myocardial region.

Duke Scholars

Published In

Cardiovasc Revasc Med

DOI

EISSN

1878-0938

Publication Date

2011

Volume

12

Issue

2

Start / End Page

75 / 81

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Thrombolytic Therapy
  • Stents
  • Risk Factors
  • Recurrence
  • Percutaneous Coronary Intervention
  • Odds Ratio
  • Myocardial Infarction
  • Male
 

Citation

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ICMJE
MLA
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Dawkins, K., Busk, M., Sorensen, J., Mortensen, L. S., Maynard, C., Stinnett, S. S., … DANAMI-2 investigators. (2011). Association between ST segment Resolution following Fibrinolytic therapy or Intracoronary stenting, and Reinfarction in the same myocardial region in the DANAMI-2 study population. Cardiovasc Revasc Med, 12(2), 75–81. https://doi.org/10.1016/j.carrev.2010.04.003
Dawkins, Kashina, Martin Busk, Jacob Sorensen, Leif S. Mortensen, Chuck Maynard, Sandra S. Stinnett, Galen S. Wagner, Henning R. Andersen, and DANAMI-2 investigators. “Association between ST segment Resolution following Fibrinolytic therapy or Intracoronary stenting, and Reinfarction in the same myocardial region in the DANAMI-2 study population.Cardiovasc Revasc Med 12, no. 2 (2011): 75–81. https://doi.org/10.1016/j.carrev.2010.04.003.
Dawkins, Kashina, et al. “Association between ST segment Resolution following Fibrinolytic therapy or Intracoronary stenting, and Reinfarction in the same myocardial region in the DANAMI-2 study population.Cardiovasc Revasc Med, vol. 12, no. 2, 2011, pp. 75–81. Pubmed, doi:10.1016/j.carrev.2010.04.003.
Dawkins K, Busk M, Sorensen J, Mortensen LS, Maynard C, Stinnett SS, Wagner GS, Andersen HR, DANAMI-2 investigators. Association between ST segment Resolution following Fibrinolytic therapy or Intracoronary stenting, and Reinfarction in the same myocardial region in the DANAMI-2 study population. Cardiovasc Revasc Med. 2011;12(2):75–81.
Journal cover image

Published In

Cardiovasc Revasc Med

DOI

EISSN

1878-0938

Publication Date

2011

Volume

12

Issue

2

Start / End Page

75 / 81

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Thrombolytic Therapy
  • Stents
  • Risk Factors
  • Recurrence
  • Percutaneous Coronary Intervention
  • Odds Ratio
  • Myocardial Infarction
  • Male