Impact of electrocardiographic morphology on clinical outcomes in patients with non-ST elevation myocardial infarction receiving coronary angiography and intervention: a retrospective study.
Clinical outcomes
Electrocardiographic morphology
Non-ST segment elevation myocardial infarction
Percutaneous coronary intervention
ST depression
Journal
PeerJ
ISSN: 2167-8359
Titre abrégé: PeerJ
Pays: United States
ID NLM: 101603425
Informations de publication
Date de publication:
2020
2020
Historique:
received:
21
10
2019
accepted:
25
02
2020
entrez:
19
5
2020
pubmed:
19
5
2020
medline:
19
5
2020
Statut:
epublish
Résumé
The impact of electrocardiography (ECG) morphology on clinical outcomes in patients with non-ST segment elevation myocardial infarction (NSTEMI) receiving percutaneous coronary intervention (PCI) is unknown. This study investigated whether different ST morphologies had different clinical outcomes in patients with NSTEMI receiving PCI. This retrospective study analyzed record-linked data of 362 patients who had received PCI for NSTEMI between January 2008 and December 2010. ECG revealed ST depression in 67 patients, inverted T wave in 91 patients, and no significant ST-T changes in 204 patients. The primary endpoint was long-term all-cause mortality. The secondary endpoint was long-term cardiac death and non-fatal major adverse cardiac events. Compared to those patients whose ECG showed an inverted T wave and non-specific ST-T changes, patients whose ECG showed ST depression had more diabetes mellitus, advanced chronic kidney disease (CKD) and left main artery disease, as well as more in-hospital mortality, cardiac death and pulmonary edema during hospitalization. Patients with ST depression had a significantly higher rate of long-term total mortality and cardiac death. Finally, multiple stepwise Cox regression analysis showed that an advanced Killip score, age, advanced CKD, prior percutaneous transluminal coronary angioplasty and ST depression were independent predictors of the primary endpoint. Among NSTEMI patients undergoing coronary angiography, those with ST depression had more in-hospital mortality and cardiac death. Long-term follow-up of patients with ST depression consistently reveals poor outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
The impact of electrocardiography (ECG) morphology on clinical outcomes in patients with non-ST segment elevation myocardial infarction (NSTEMI) receiving percutaneous coronary intervention (PCI) is unknown. This study investigated whether different ST morphologies had different clinical outcomes in patients with NSTEMI receiving PCI.
METHODS
METHODS
This retrospective study analyzed record-linked data of 362 patients who had received PCI for NSTEMI between January 2008 and December 2010. ECG revealed ST depression in 67 patients, inverted T wave in 91 patients, and no significant ST-T changes in 204 patients. The primary endpoint was long-term all-cause mortality. The secondary endpoint was long-term cardiac death and non-fatal major adverse cardiac events.
RESULTS
RESULTS
Compared to those patients whose ECG showed an inverted T wave and non-specific ST-T changes, patients whose ECG showed ST depression had more diabetes mellitus, advanced chronic kidney disease (CKD) and left main artery disease, as well as more in-hospital mortality, cardiac death and pulmonary edema during hospitalization. Patients with ST depression had a significantly higher rate of long-term total mortality and cardiac death. Finally, multiple stepwise Cox regression analysis showed that an advanced Killip score, age, advanced CKD, prior percutaneous transluminal coronary angioplasty and ST depression were independent predictors of the primary endpoint.
CONCLUSIONS
CONCLUSIONS
Among NSTEMI patients undergoing coronary angiography, those with ST depression had more in-hospital mortality and cardiac death. Long-term follow-up of patients with ST depression consistently reveals poor outcomes.
Identifiants
pubmed: 32419982
doi: 10.7717/peerj.8796
pii: 8796
pmc: PMC7211404
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e8796Informations de copyright
©2020 Wu et al.
Déclaration de conflit d'intérêts
The authors declare there are no competing interests.
Références
N Engl J Med. 2001 Jun 21;344(25):1879-87
pubmed: 11419424
Int J Cardiol. 2016 Oct 1;220:166-72
pubmed: 27379919
Lancet. 2005 Sep 10-16;366(9489):914-20
pubmed: 16154018
Am J Cardiol. 2010 Nov 15;106(10):1397-403
pubmed: 21059427
Circulation. 1999 Aug 10;100(6):599-607
pubmed: 10441096
BMJ Open. 2014 Feb 21;4(2):e004425
pubmed: 24561498
Circulation. 2014 Dec 23;130(25):2354-94
pubmed: 25249586
BMJ. 2006 Nov 25;333(7578):1091
pubmed: 17032691
EuroIntervention. 2011 Oct 30;7(6):697-704
pubmed: 21986328
J Am Coll Cardiol. 2006 Feb 7;47(3):654-60
pubmed: 16458151
Am Heart J. 2011 Nov;162(5):875-883.e1
pubmed: 22093204
Am J Cardiol. 1999 Aug 15;84(4):379-85
pubmed: 10468072
JAMA. 2004 Jun 9;291(22):2727-33
pubmed: 15187054
Int Heart J. 2007 Jul;48(4):443-54
pubmed: 17827816
Eur Heart J. 2014 Apr;35(13):844-52
pubmed: 24353280
Eur Heart J. 2009 Mar;30(5):549-57
pubmed: 19201761
J Thromb Thrombolysis. 2016 Apr;41(3):464-74
pubmed: 26001907
Eur Heart J. 2007 Jul;28(13):1598-660
pubmed: 17569677
Heart. 2004 Aug;90(8):902-7
pubmed: 15253964
J Am Coll Cardiol. 1997 Jul;30(1):133-40
pubmed: 9207634
JAMA. 2000 Aug 16;284(7):835-42
pubmed: 10938172
Catheter Cardiovasc Interv. 2005 May;65(1):1-7
pubmed: 15816055
Clin J Am Soc Nephrol. 2009 Jun;4(6):1032-43
pubmed: 19423566
Clin Cardiol. 2011 Apr;34(4):249-53
pubmed: 21432857