E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don¡¯t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-013

Clinical Outcomes of ST Segment Resolution Following Primary Percutaneous Coronary Intervention

By Khaled Shunnar, Alaa Rahhal, Mhd Baraa Habib, Mohammad Altermanini, Yousef Mohammed Ali Hailan, Mohammad AlKhateeb, Mohamed Salah Abdelghani, Osama Nweiran AlKhalaila, Mohanad Jamal Shehadeh, Abdul Rahman Arabi

Presenter

Khaled Shunnar

Authors

Khaled Shunnar1, Alaa Rahhal2, Mhd Baraa Habib2, Mohammad Altermanini2, Yousef Mohammed Ali Hailan2, Mohammad AlKhateeb3, Mohamed Salah Abdelghani4, Osama Nweiran AlKhalaila2, Mohanad Jamal Shehadeh5, Abdul Rahman Arabi2

Affiliation

Heart Hospital, Qatar1, Hamad Medical Corporation, Qatar2, Geisinger Medical Center, USA3, HMC Heart Hospital, Qatar4, Rochester Regional Health, USA5
View Study Report
TCTAP A-013
ACS/AMI

Clinical Outcomes of ST Segment Resolution Following Primary Percutaneous Coronary Intervention

Khaled Shunnar1, Alaa Rahhal2, Mhd Baraa Habib2, Mohammad Altermanini2, Yousef Mohammed Ali Hailan2, Mohammad AlKhateeb3, Mohamed Salah Abdelghani4, Osama Nweiran AlKhalaila2, Mohanad Jamal Shehadeh5, Abdul Rahman Arabi2

Heart Hospital, Qatar1, Hamad Medical Corporation, Qatar2, Geisinger Medical Center, USA3, HMC Heart Hospital, Qatar4, Rochester Regional Health, USA5

Background

Resolution of ST elevation (STE) is the hallmark of successful thrombolysis for ST- Elevation Myocardial Infarction (STEMI). The effect of persistent STE on in-hospital outcomes following primary percutaneous coronary intervention (PPCI) is not well established.

Methods

In this single-center retrospective cohort analysis, all patients admitted between Jan 1,2016 and Sep 30,2018 with a diagnosis of STEMI who underwent PPCI were included. Complete resolution was defined as >70% decrease in the STE sum on the first ECG following PPCI. Partial resolution denoted a 30-70% decrease, and persistent STE denoted <30% decrease, or any increase in the STE sum. The study population was divided into two groups: (1) resolved STE incorporating complete and partial resolution; (2) persistent STE incorporating persistent and increased STE. Using multivariate logistic regression, we compared the rates of in-hospital mortality, cardiogenic shock, ICU admission, clinical heart failure, and readmission for a cardiac reason and heart failure between the study groups.

Results

We included 1,250 patients in the analysis. Most of the patients were male (96 %) with a mean age of 52¡¾10 years. More than three-quarters were Asian. Compared with patients with resolved STE, patients with persistent STE had higher risk of clinical heart failure (24% vs 12%, adjusted odds ratio 1.7 [95% Confidence Interval 1.2-2.5], p-value 0.003), cardiogenic shock (12.1% vs 5.3%, aOR 2.7 [95% CI 1.73-4.24], p-value <0.001), in-hospital mortality (5.1% vs 2.1%, aOR 4.8 [95% CI 2.35-9.88], p-value < 0.001), and readmission for heart failure (6.9% vs. 1.6%, aOR 3.9[95% CI 1.95-7.82], p-value <0.001).

Conclusion

Persistent STE following PPCI is a quick clinical indicator of in-hospital adverse outcomes as well as readmission. Future studies may explore interventions, such as early intensive medical therapy, that can improve outcomes in this population.