Predictors of ST-Segment Resolution and Its Relationship With Outcomes in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract

ST-segment resolution (STR) is a critical parameter in ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI). This study aimed to determine predictors of incomplete STR and their relationship with adverse cardiovascular outcomes. The study retrospectively included 508 consecutive STEMI patients who underwent pPCI in our hospital between January 2020 and December 2020. Patients with STR < 70% were included in the incomplete STR group (n = 182), and patients with STR ≥ 70% were included in the complete STR group (n = 326). Multivariable analysis identified in-stent restenosis (Odds ratio [OR] = 5.145), prolonged ischemic time (OR = 1.100), and left ventricular ejection fraction (LVEF; OR = 0.968) as independent predictors. Receiver operating curve (ROC) analysis found 4.5 hours of ischemic time and 49% LVEF as cutoff values. Kaplan-Meier analyses showed that incomplete STR correlated with greater 1- and 5-year mortality. In our study, the independent predictors of incomplete STR were LVEF, in-stent restenosis, and total ischemic time. In addition, incomplete STR was associated with in-stent restenosis, in-hospital, 1-year, and 5-year all-cause mortality. Our findings may prove useful in managing STEMI patients.