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Title
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Incidence and significance of spontaneous ST segment re-elevation after reperfused anterior acute myocardial infarction : relationship with infarct size, adverse remodeling, and events at 1 year
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Author
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Abstract
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| Background: Up to 25% of patients with ST elevation myocardial infarction (STEMI) have ST segment re-elevation after initial regression post-reperfusion and there are few data regarding its prognostic significance. Methods and Results: A standard 12-lead electrocardiogram (ECG) was recorded in 662 patients with anterior STEMI referred for primary percutaneous coronary intervention (PPCI). ECGs were recorded 60-90 min after PPCI and at discharge. ST segment re-elevation was defined as a >= 0.1-mV increase in STMax between the post-PPCI and discharge ECGs. Infarct size (assessed as creatine kinase [CK] peak), echocardiography at baseline and follow-up, and all-cause death and heart failure events at 1 year were assessed. In all, 128 patients (19%) had ST segment re-elevation. There was no difference between patients with and without re-elevation in infarct size (CK peak [mean +/- SD] 4,231 +/- 2,656 vs. 3,993 +/- 2,819 IU/L; P=0.402), left ventricular (LV) ejection fraction (50.7 +/- 11.6% vs. 52.2 +/- 10.8%; P=0.186), LV adverse remodeling (20.1 +/- 38.9% vs. 18.3 +/- 30.9%; P=0.631), or all-cause mortality and heart failure events (22 [19.8%] vs. 106 [19.2%]; P=0.887) at 1 year. Conclusions: Among anterior STEMI patients treated by PPCI, ST segment re-elevation was present in 19% and was not associated with increased infarct size or major adverse events at 1 year. |
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Language
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English
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Source (journal)
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Circulation journal. - Kyoto
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Publication
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Kyoto
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2018
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ISSN
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1346-9843
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DOI
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10.1253/CIRCJ.CJ-17-0671
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Volume/pages
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82
:5
(2018)
, p. 1379-1386
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ISI
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000432404400026
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Pubmed ID
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28943533
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Full text (Publisher's DOI)
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Full text (open access)
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