Long-term clinical outcomes and prognoses of ST-segment elevation myocardial infarction patients who present with tombstoning ST-segment elevation
Tanık, Çınar, Şimşek, Güngör, Avcı, Tanboga, Karabay (2020) Long-term clinical outcomes and prognoses of ST-segment elevation myocardial infarction patients who present with tombstoning ST-segment elevation Ann Noninvasive Electrocardiol (IF: -1) 25(2) e12725
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Abstract
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.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.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).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.© 2019 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals, Inc.
Links
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358892http://www.ncbi.nlm.nih.gov/pubmed/31707765
http://dx.doi.org/10.1111/anec.12725
