ST-segment resolution as a marker for severe myocardial fibrosis in ST-segment elevation myocardial infarction

BMC Cardiovasc Disord. 2021 Sep 21;21(1):455. doi: 10.1186/s12872-021-02269-y.

Abstract

Objective: To investigate the relationship between ST-segment resolution (STR) and myocardial scar thickness after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI).

Methods: Forty-two STEMI patients with single-branch coronary artery stenosis or occlusion were enrolled. ST-segment elevations were measured at emergency admission and at 24 h after PCI. Late gadolinium-enhanced cardiac magnetic resonance imaging (CMR-LGE) was performed 7 days after PCI to evaluate myocardial scars. Statistical analyses were performed to assess the utility of STR to predict the development of transmural (> 75%) or non-transmural (< 75%) myocardial scars, according to previous study.

Results: The sensitivity and specificity of STR for predicting transmural scars were 96% and 88%, respectively, at an STR cut-off value of 40.15%. The area under the curve was 0.925. Multivariate logistic proportional hazards regression analysis disclosed that patients with STR < 40.15% had a 170.90-fold higher probability of developing transmural scars compared with patients with STR ≥ 40.15%. Pearson correlation and linear regression analyses showed STR percentage was significantly associated with myocardial scar thickness and size.

Conclusion: STR < 40.15% at 24 h after PCI may provide meaningful diagnostic information regarding the extent of myocardial scarification in STEMI patients.

Keywords: Myocardial scar; Percutaneous coronary intervention; ST-elevation myocardial infarction; ST-segment resolution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Coronary Occlusion / diagnostic imaging*
  • Coronary Occlusion / pathology
  • Coronary Occlusion / therapy
  • Coronary Stenosis / diagnostic imaging*
  • Coronary Stenosis / pathology
  • Coronary Stenosis / therapy
  • Cross-Sectional Studies
  • Electrocardiography*
  • Female
  • Fibrosis
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Myocardium / pathology*
  • Percutaneous Coronary Intervention
  • Predictive Value of Tests
  • Reproducibility of Results
  • ST Elevation Myocardial Infarction / diagnostic imaging*
  • ST Elevation Myocardial Infarction / pathology
  • ST Elevation Myocardial Infarction / therapy
  • Time Factors
  • Treatment Outcome