Clinical presentation and outcome of patients with ST-segment elevation myocardial infarction without culprit angiographic lesions
| Autor: | Mistre Alemayehu, Shahar Lavi, Marlene Allegretti, Ashlay A. Huitema, Connie Chomicki, Andrew Yadegari, Tina Zhu |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Myocardial Infarction Coronary Angiography Chest pain Culprit Electrocardiography Cardiac Conduction System Disease Heart Conduction System Internal medicine medicine Humans ST segment cardiovascular diseases Myocardial infarction Depression (differential diagnoses) Aged Brugada Syndrome Aged 80 and over medicine.diagnostic_test business.industry Arrhythmias Cardiac General Medicine Middle Aged medicine.disease Treatment Outcome Case-Control Studies Cardiology Etiology Female medicine.symptom Presentation (obstetrics) Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular Revascularization Medicine. 16:217-220 |
| ISSN: | 1553-8389 |
| DOI: | 10.1016/j.carrev.2015.04.004 |
| Popis: | Patients diagnosed with ST-segment elevation myocardial infarction (STEMI) are occasionally found to have no culprit lesion on coronary angiography and are classified as presenting with false-positive STEMI. The clinical presentation and outcomes of these patients need to be further explored. In this case-controlled study, 259 consecutive patients with true code STEMI were compared to 104 consecutive STEMI patients without culprit lesions on emergent coronary angiography. We compared the clinical presentation, electrocardiographic features, etiology, and outcomes of the two groups. STEMI patients without culprit lesions were less likely to have typical chest pain (46% vs. 79%, P < 0.01). The ST-elevation in the group without culprit lesion was more likely to be concave (56% vs. 31%, P < 0.01), with less reciprocal ST-depression (19% vs. 71%, P < 0.01). The group without culprit lesions had a higher rate of ventilator support requirement (12.4% vs. 5.4%, P = 0.02), and higher rate of 30-day mortality (11.0% vs. 5.9%, P = 0.02). However, after excluding the patients with out-of-hospital cardiac arrests from both groups, the difference was no longer significant (P = 0.40 and 0.34 respectively). The relative poor outcomes of patients with false-positive code STEMI reflect the severity of their underlying medical condition. Careful history and review of ECG may help differentiate this group from true STEMI. |
| Databáze: | OpenAIRE |
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