Impact of Hypertension on Late Post-Reperfusion Abortion of Electrocardiographic Signs of ST Elevation Myocardial Infarction in Patient With Multivessel Coronary Artery Disease

Abstract

Objective: Objective of the study was to investigate the predictors of late postreperfusion abortion of electrocardiographic signs of ST elevation myocardial infarction (STEMI), because the early or late abortion of STEMI signs is important challenge of reperfusion therapy, especially in patients with multivessel coronary disease (MVD). Design and method: A retrospective analysis of 12 months post-reperfusion period of 77 patients treated by primary percutaneous coronary intervention (PPCI) was performed using the data of ST segment and T wave resolution and evolution of QRS score, calculated from serial 12 lead ECG, registered before, after PPCI, after 1 and 7 days, and after 1, 6 and 12 month after PPCI. Echocardiography examination was performed at discharge and after 12 months. Severity of MVD was evaluated by Syntax score (SXS). Patients with full abortion of ECG STEMI signs after 12 months were selected to 1st group (n=35), and patients with not resolved QRS score (6.42 ± 3.17; p<0.00001), ST dislocation (1.05 ± 1.37 mm; p<0.00001) with inverted T wave were selected to 2nd group (n=42).- Results: The majority of initial characteristics of 1st and 2nd groups as the age, summarized ST elevation, left ventricle ejection fraction (LVEF), myocardial mass [...,] ference. However in 1st group of patients the pre- interventional QRS score (1.1 ± 1.76 vs 5.1 ± 3.38; p<0.0001), systolic arterial pressure (133.9 ± 27.2 vs 148.2 ± 26.2 p<0.03) and diastolic arterial pressure (79.9 ± 13.6 vs 92.1 ± 13.9; p<0.0003) [...] according to all ECG characteristics, but patients of 1st group had additionally the higher LVEF (40.5± 7.95 vs 48.28 ± 6.23; p<0.00001), lower MMI (92.6± 16.5 vs 106.5± 20.1 p<0.003) and EDDI (22.5 ± 2.38 vs 24.8 ± 3.3; p<0.002). Conclusions: The large initial myocardial injury zone and elevated pre-interventional arterial pressure may be considered as negative predictors in achievement of lat