Long-term clinical outcomes and prognoses of ST-segment elevation myocardial infarction patients who present with tombstoning ST-segment elevation
Annals of Noninvasive Electrocardiology, cilt.25, sa.2, 2020 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 25 Sayı: 2
- Basım Tarihi: 2020
- Doi Numarası: 10.1111/anec.12725
- Dergi Adı: Annals of Noninvasive Electrocardiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Agricultural & Environmental Science Database, CINAHL, EMBASE, MEDLINE
- Anahtar Kelimeler: long-term clinical events, long-term mortality, ST-segment elevation myocardial infarction, Tombstoning ST-segment elevation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: Although patients with tombstoning ST-segment elevation (Tomb-ST) usually have poor in-hospital and short-term survival rates, no studies have examined the long-term clinical outcomes and prognosis of ST-segment elevation myocardial infarction (STEMI) patients who have this electrocardiographic pattern. Therefore, we aimed to evaluate the long-term clinical events and mortality of such patients in this study. Methods: In this retrospective analysis, we included 335 consecutive patients who were diagnosed with acute anterior wall-STEMI from January 2015 to June 2018. The criteria for the definition of Tomb-ST were accepted as provided in a previous study. Endpoints of the study were the incidence of significant in-hospital and long-term major adverse clinical events (MACE) including the composite of total death, myocardial reinfarction, and hospitalizations due to heart failure. Results: Patients who presented with Tomb-ST had significantly higher in-hospital and long-term mortality (10% [n = 12 patients] vs. 2.3% [n = 5 patients]; p < 0.001and 6.5% [n = 7 patients] vs. 1.9% [n = 4 patients]; p =.04, respectively). In a multivariate traditional and penalized Cox proportional hazard regression analysis, this type of electrocardiographic pattern was found as independent predictor of long-term MACE (Odds ratio [OR]: 3.82, 95% confidence interval [CI]: 1.91–7.63, p <.001 and OR: 4.36, 95% CI: 1.97–9.66, p <.001, respectively). Conclusion: In the present study, we observed that the presence of Tomb-ST might be an independent predictor of long-term MACE in STEMI patients. To the best of our knowledge, this is the first study to evaluate the long-term MACE of such patients.